Tips For Use Of Novel Method For Easy Adjustment Of Appropriate Artificial Chordae Length In Patients Undergoing Minimally Invasive Mitral Repair
Hiroyuki Nishi, MD, Kimihiro Kurose, MD, Kohei Horikawa, MD, Go Kanazawa, MD, Toshiki Takahashi, MD.
Department of Cardiovascular Surgery, Osaka Police Hospital, Osaka, Japan.
OBJECTIVE: We present our experience using the Memo 3D Rechord, a complete prosthetic ring associated with a temporary chordal guide system, which is comprised of yellow loops that function as a reference for automatically determining the height of neo-chordae. This video presents some tips for successful use of this novel system as part of a minimally invasive right thoracotomy approach.
A 44-year-female with severe mitral regurgitation (A2-3 prolapse) underwent mitral valve repair via right thoracotomy approach. At first, following careful inspection, the center of anterior leaflet were determined. Two PTFE sutures were passed through the posterior papillary muscle and the free margin of the A2-3 leaflet. By performing saline test, we confirmed appropriate position of the PTFE chordae. After parachuting the annuloplasty ring, PTFE chordae were passed through the loops, and the free margin of the A2-3 leaflet is brought to the posterior annulus. Then, PTFE was tied and the temporary loop system is removed, which provided appropriate chordal length.
RESULTS: Postoperative trans-esophageal echocardiography findings revealed trivial mitral valve regurgitation. There was no need to adjust the position of artificial chordae.
CONCLUSIONS: Our mitral valve repair using Memo 3D rechord with some tricks is a simple and reproducible technique suitable for leaflet prolapse.
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