Performance and healing of an expanded polytetrafluoroethylene multichordal device at 6 months after repair of mitral leaflet flail in swine.

Objective: Repairing a prolapsed mitral valve that involves multiple cusps is procedurally complicated and carries a higher risk of failure when performed with individual neochordae. Inserting multiple neochordae into the papillary muscle, sizing, and aligning them in a manner that can restore coaptation is challenging. A multichordal mitral valve apparatus (MitraPatch) with a single neopapillary muscle section, 4 neochordae with each chord ending in a neoleaflet section, was developed.

Use of a New Expanded Polytetrafluoroethylene Multichordal Mitral Apparatus (MitraPatch) to Repair Complex Mitral Valve Lesions.

Objective: We report a new expanded polytetrafluoroethylene multichordal mitral apparatus (MitraPatch) to simplify mitral repairs involving multiple cusps and sought to describe the surgical technique and demonstrate the efficacy of the device.

Methods: MitraPatch was laser cut from a single sheet of expanded polytetrafluoroethylene and mounted on a custom-designed handle. Surgical technique to deploy the apparatus on the native mitral valve was developed in ex vivo porcine hearts.

Pre-clinical Experience with a Multi-Chordal Patch for Mitral Valve Repair.

Surgical repair of flail mitral valve leaflets with neochordoplasty has good outcomes, but implementing it in anterior and bi-leaflet leaflet repair is challenging. Placing and sizing individual neochordae is time consuming and error prone, with persistent localized flail if performed incorrectly. In this study, we report our pre-clinical experience with a novel multi-chordal patch for mitral valve repair.

The effects on cordal and leaflet stiffness of severe apical, posterior, and outward papillary displacement in advanced ventricular mechanism heart failure and mitral insufficiency.

Background And Aim Of The Study: During the normal opening and closing of the mitral valve there is a finely tuned interaction between the changing ventricular dimensions and fluid pressures, the movement of papillary muscles apically, posteriorly and apart during diastole and in the opposite direction during systole, interactions between leaflets and their controlling cords, and the fluid dynamic forces being exerted on them. The main rough zone cords and the smooth zone of the anterior leaflet are under maximum tension in systole, but retain some tension throughout the cycle. The free edge cords and the rough zone of the leaflets can have no or minimal tension during diastole, and much less tension than the main rough zone cords and the smooth zone in systole.

Mitral valve repair with artificial chordae: a review of its history, technical details, long-term results, and pathology.

Mitral valve repair is considered the procedure of choice for correcting mitral regurgitation in myxomatous disease, providing long-term results that are superior to those with valve replacement. The use of artificial chordae to replace elongated or ruptured chordae responsible for mitral valve prolapse and severe mitral regurgitation has been the subject of extensive experimental work to define feasibility, reproducibility, and effectiveness of this procedure. Artificial chordae made of autologous or xenograft pericardium have been replaced by chordae made of expanded polytetrafluoroethylene (PTFE), a material with the unique property of becoming covered by host fibrosa and endothelium.

Quattro valve trial at mid-term: December 1996 to November 2004.

Background And Aim Of The Study: The Quattro valve is a stentless pericardial mitral bioprosthesis that is treated with a post-tanning aldehyde capping designed to reduce calcification. A prospective trial was started in December 1996; herein are reported the results of the three centers that performed the surgery and followed up patients in the majority of cases. Young patients were deliberately included in the trial.