Our Summary

This research paper deals with a specific procedure known as mitral valve repair where artificial cords, made from a material called polytetrafluoroethylene, are used to replace natural ones in the heart. The researchers were particularly interested in cases where these artificial cords failed, causing a condition known as mitral regurgitation, where the blood flows backward in the heart.

They reviewed cases of complications from using these artificial cords and found 26 instances where they ruptured. Most of these were isolated cases and a few others experienced mitral regurgitation due to other reasons, mostly likely errors in the procedure, not due to the failure of the artificial cords.

The researchers found that the artificial cords generally retained their original length and flexibility, and were covered by the body’s own tissues. Rupture was mostly related to the size of the suture used. Some mild calcification was observed but did not interfere with the function of the cords and there were no infections reported.

The researchers concluded that using these artificial cords for mitral valve repair usually gives excellent long-term results. However, there is a small risk that the cords can rupture later on, leading to the need for another operation. They advise doctors to be aware of this potential complication when monitoring patients who have undergone this procedure.

FAQs

  1. What is mitral valve repair using expanded polytetrafluoroethylene sutures?
  2. What are the potential complications after mitral valve repair related to the use of neo-chordae?
  3. What are the findings from the pathological investigation after mitral valve repair using artificial neo-chordae?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve repair using artificial neo-chordae is to ensure regular follow-up appointments to monitor the durability and function of the neo-chordae. This can help detect any potential complications, such as chordal rupture, early on and allow for timely intervention if needed. It is also important to follow any specific post-operative care instructions provided by your healthcare team to optimize the long-term success of the mitral valve repair.

Suitable For

Patients who are typically recommended mitral valve repair include those with:

  • Mitral valve regurgitation
  • Mitral valve prolapse
  • Mitral valve stenosis
  • Mitral valve dysfunction due to rheumatic heart disease
  • Patients with congenital heart defects affecting the mitral valve

Mitral valve repair is often preferred over replacement, as it preserves the natural anatomy and function of the valve, leading to better long-term outcomes. Patients who are considered good candidates for mitral valve repair are usually younger, have less severe valve damage, and have better overall heart function. However, the decision to undergo mitral valve repair or replacement ultimately depends on the individual patient’s specific condition and the expertise of the cardiac surgeon.

Timeline

  • Before mitral valve repair: The patient may experience symptoms such as shortness of breath, fatigue, and palpitations due to mitral valve regurgitation. They may undergo diagnostic tests such as echocardiograms to determine the severity of the condition.

  • During mitral valve repair: The patient undergoes surgery to repair the mitral valve, which may involve the use of expanded polytetrafluoroethylene sutures to replace mitral chordae tendineae. The procedure aims to restore proper valve function and reduce or eliminate mitral regurgitation.

  • After mitral valve repair: The patient undergoes a recovery period in the hospital, where they will be monitored for any complications. They may experience improvements in their symptoms and overall quality of life. In some cases, there may be complications related to the use of neo-chordae, such as rupture leading to recurrent mitral regurgitation. This may require reoperation to address the issue and ensure the long-term success of the mitral valve repair. Regular follow-up appointments and monitoring are crucial to detect and address any potential complications.

What to Ask Your Doctor

  1. How likely is it that the artificial neo-chordae used in my mitral valve repair procedure could fail?

  2. What symptoms should I watch out for that may indicate a failure of the neo-chordae?

  3. How often should I have follow-up appointments to monitor the function of the neo-chordae?

  4. If a failure of the neo-chordae does occur, what are the treatment options available to me?

  5. Are there any specific lifestyle changes or precautions I should take to reduce the risk of neo-chordae failure?

  6. Are there any factors that may increase my risk of neo-chordae failure, such as high blood pressure or certain medications?

  7. How long can I expect the artificial neo-chordae to last before needing potential replacement or repair?

  8. What is the success rate of mitral valve repair using artificial neo-chordae in general?

  9. Are there any alternative treatment options available to me besides mitral valve repair with artificial neo-chordae?

  10. What is the overall prognosis for patients who undergo mitral valve repair with artificial neo-chordae?

Reference

Authors: Vendramin I, Milano AD, Pucci A, Lechiancole A, Sponga S, Bortolotti U, Livi U. Journal: J Card Surg. 2022 Nov;37(11):3722-3728. doi: 10.1111/jocs.16937. Epub 2022 Sep 18. PMID: 36116053