Echocardiographic Method to Determine the Length of Neochordae Reconstruction for Mitral Repair.

The Annals of Thoracic Surgery
Fahd MakhdomMichael W A Chu

Abstract

We evaluated a novel formula using preoperative transesophageal echocardiographic measurements to determine neochordae length for repair of degenerative mitral regurgitation (MR). The formula is based on measuring the distance from the adjacent papillary head to the intended coaptation zone of the flail/prolapsing leaflet segment and subtracting the redundant leaflet length. Between 2008 and 2017, 264 consecutive patients underwent mitral valve repair (82.2% endoscopic, minimally invasive approach and 17.8% sternotomy) with neochordae loop reconstruction (68.6% posterior, 6.4% anterior, and 25% bileaflet repair). Mean patient age was 63 ± 13.6 years, 73.5% were men, and mean left ventricular ejection fraction was 63.1% ± 6.7%. Mitral valve repair was successful in 100% of patients, with no patient requiring conversion to replacement. Neochordae length measurement was accurate in 259 patients (98%), with 4 patients requiring conversion to resection and 1 patient requiring longer anterior leaflet neochordae. Median anterior and posterior neochordae lengths were 27 mm (range, 18-32) and 17 mm (range, 9-27), respectively. Intraoperative transesophageal echocardiography demonstrated no or trace residual MR in 254 patients and mild r...Continue Reading

References

Nov 7, 1998·The Journal of Thoracic and Cardiovascular Surgery·A M GillinovF D Loop
Jun 12, 2008·The Journal of Thoracic and Cardiovascular Surgery·Loris SalvadorCarlo Valfrè
May 26, 2009·The Annals of Thoracic Surgery·Joerg SeeburgerFriedrich W Mohr
May 26, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Joerg SeeburgerFriedrich W Mohr
Sep 11, 2012·Interactive Cardiovascular and Thoracic Surgery·Michael IbrahimThanos Athanasiou
Mar 21, 2017·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·William A ZoghbiNeil J Weissman

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Citations

Aug 25, 2020·The Annals of Thoracic Surgery·Tirone E David

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