BackgroundChordaereconstructionisoneofthekeypointsinrepairofmitralvalveprolapse,especiallyforanteriorleaflets.Hereweintroduceourexperiencesofusingecho-determinednormalchordaellengthtomaketheloopspreoperativelyandrebuildtheelongated/rupturedchordaeintraoperatively.MaterialsandmethodFromJune2011toFebruary2012,19consecutivecaseswithmitralanteriorleafletprolapseunderwentvalverepairprocedures.Echocardiographywasusedtodeterminethelengthofnormalchordaethattheprolapsedleafletsshouldhavefornormalcoaptation.Theartificialchordaewasfabricatedinloopsaccordingtoecho-determinedlength.ResultsAllpatientssurvivedtheoperations.2.8preoperativelypreparedloopswereusedperpatienttorestoretheanteriorleaflets,aswellasposteriorleaflets.Artificialmitralvalveringswereappliedto18patientsformitralannuloplasty.16patientswereunderwentdifferentconcomitantoperations.Echocardiographicresultsatdischargeshowedthatgradeofmitralregurgitation,leftventricularend-diastolic,end-systolicdimensiondecreaseddefinitely,respectivelyfrom3.26±1.10,53.79±15.03mm,33.00±12.05mmpreoperativelyto0.47±0.61(P<0.01),44.74±10.28mm(P<0.01),30.16±10.58mm(P<0.05)postoperatively.AllpatientsimprovedclinicallyandNYHAfunctionalclassdecreasedsignificantlyfrom2.17±0.81to1.12±0.33.ConclusionReconstructionofprolapsedanteriorleafletchordaewithartificialloopsinpreoperativelyecho-determinedlengthissafeandeffective,andinitialclinicaloutcomeissatisfactory.
