Key result
Chordal cutting through aortotomy safely eliminates ischemic MR without perioperative morbidity in initial cases.
Why the study?
Does the chordal cutting technique through aortotomy safely and effectively treat severe ischemic mitral regurgitation due to tenting phenomenon?
Case Report (n=5)
Does the chordal cutting technique through aortotomy safely and effectively treat severe ischemic mitral regurgitation due to tenting phenomenon?
Chordal cutting through aortotomy appears to be a safe and effective novel surgical technique for treating severe ischemic mitral regurgitation due to tenting.
Supports feasibility of chordal cutting via aortotomy in ischemic MR; leaves open durability and comparative efficacy in larger trials.
OBJECTIVE: To describe original surgical treatment in patients with ischemic mitral valve regurgitation due to tenting phenomenon. BACKGROUND: The optimal surgical treatment of ischemic mitral regurgitation (MR) in patients with coronary artery disease is controversial. The standard treatment is revascularization and reduction annuloplasty. We describe the first clinical application of an original technique to treat MR, through aortotomy. The chordal cutting technique was described first in experimental studies by Messas et al. METHODS: The procedure consisted in cutting the 2 strut chordae of the anterior mitral valve through a small aortotomy, using a brief conventional cardiopulmonary bypass. All the cases were controlled at the end of the procedure by transesophageal echocardiography (TEE). RESULTS: Five patients were treated using this technique; the procedure was brief, effective and safe in all the patients. TEE showed no mitral regurgitation. No preoperative morbidity or mortality occurred and post-operative course was uneventful. CONCLUSION: Chordal cutting technique through aortotomy is a safe and effective technique that should be considered to treat severe ischemic mitral regurgitation due to tenting phenomenon.
No takes yet. Share an insight, caveat, or question.
Fayad et al. (2007) conducted a case report in Chronic ischemic mitral regurgitation due to tenting phenomenon (n=5). Chordal cutting technique through aortotomy was evaluated on Procedural success, residual mitral regurgitation, and perioperative morbidity/mortality. The chordal cutting technique through aortotomy was safely performed in 5 patients with ischemic mitral regurgitation, resulting in no residual regurgitation or perioperative morbidity.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: