Key result
Secondary chordae transection and downsized annuloplasty during CABG linked to 0% significant MR recurrence at six months.
Why the study?
Relying solely on restrictive annuloplasty for ischemic mitral regurgitation repair has an unacceptable recurrence rate, and transection of secondary chordae has been proposed as an adjunctive procedure to improve results.
Does transection of secondary chordae with downsized ring annuloplasty prevent recurrence of significant mitral regurgitation in patients with severe ischemic mitral regurgitation undergoing CABG?
Observational (n=20)
No
Does transection of secondary chordae with downsized ring annuloplasty prevent recurrence of significant mitral regurgitation in patients with severe ischemic mitral regurgitation undergoing CABG?
Transection of secondary chordae combined with downsized ring annuloplasty during CABG is a safe adjunctive procedure that effectively prevents early recurrence of significant ischemic mitral regurgitation.
Answers are grounded in this paper and cite their sources.
May support chordal transection with annuloplasty in ischemic MR repair; leaves open durability and benefit in randomized trials.
Background: Relying solely on restrictive annuloplasty for the repair of ischemic mitral regurgitation is associated with an unacceptable rate of recurrence. Transection of secondary chordae as an adjunctive procedure has been proposed to improve results. Patient and methods: This is a prospective observational study including 20 patients who underwent mitral repair using downsized annuloplasty ring and transection of the secondary chordae, at the time of CABG at the Cardiothoracic Surgery Department of Cairo University Hospitals through the period between March 2016 and October 2018. The primary outcome being examined was the recurrence of significant mitral regurgitation at 6 months postoperatively. Secondary outcomes included coaptation length and ejection fraction. Results: The mean age was 57.5 ± 6.9 years. The mean ejection fraction was 45.1 ± 11%. There was one early mortality (5%). At 6 months postoperatively, there was no incidence of recurrence of significant mitral regurgitation. Coaptation length was quite satisfactory (7.2 ± 0.67 mm). Conclusion: Transection of secondary chordae is a safe and simple option. It may be beneficial when performed in combination with downsized ring annuloplasty in patients with low-risk ischemic mitral regurgitation.
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Derbala et al. (2021) conducted an observational in Severe Ischemic Mitral Regurgitation (n=20). Transection of secondary chordae with downsized ring annuloplasty was evaluated on Recurrence of significant mitral regurgitation at 6 months postoperatively. Transection of secondary chordae combined with downsized ring annuloplasty during CABG resulted in a 0% recurrence rate of significant mitral regurgitation at 6 months.
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