A new simplified technique for artificial chordae implantation in mitral valve repair with its early results

Background: Many techniques in mitral valve repair (MVR) have been reported with successful long-term results. The aim of this study is to present our simplified technique in artificial chordae replacement for MVR, and reporting its short-term outcomes. Methods: We present a prospective single-surgeon experience. A new simplified artificial chordae implantation technique has been used to repair mitral valves. Postoperative echocardiography at 0, 6, then every 12 months is used to control the results. Endpoints involved freedom from mitral regurgitation (MR), reoperation and major adverse cardiac and cerebrovascular events (MACCE). Results: Between 01/2016 and 01/2018, 57 consecutive patients undergo MVR using this technique are evaluated. Mean age was 63.6±10.1 years and 68.4% were male. Mitral valve pathology was mainly degenerative (52, 91.2%) or healed endocarditis (5, 8.8%). Besides chordae replacement (3.6±1.1 per patient), annuloplasty was used in all patients to correct annulus dilation and stabilize the repair. Mean cross-clamping time was 53±13.4 minutes in isolated MVR and 69.4±31.1 minutes in concomitant procedures. Postoperative outcomes reported two mortalities. Discharge echocardiography reported mild MR in 4 patients and the rest of patients had non-to trace regurgitation. Follow-up results within a mean of 19.3±8.5 months reported no significant MR or need for reoperation and three more (non-valve related) mortalities. Conclusions: Our simplified technique allows to reduce the number of used chordae and re-correction if needed, which consequently reduces cross-clamping and bypass time especially in endoscopic MVR. Good intraoperative and short-term results are reported. These results are still under investigation to prove long-term stability of the repair.