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Eur J Cardiothorac Surg 2003;24:653-655
© 2003 Elsevier Science NL

How-to-do-it

Simplified chordal reconstruction: ‘oblique’ placement of artificial chordae tendineae in mitral valve replacement

Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan

Received 3 June 2003; received in revised form 11 July 2003; accepted 17 July 2003.

^* Corresponding author. Tel.: +81-75-751-3780; fax: +81-75-751-4960
e-mail: masakom{at}kuhp.kyoto-u.ac.jp

We describe a novel chordal-sparing technique of mitral valve replacement using minimum number of artificial chordae tendineae in patients with rheumatic mitral stenosis. Continuity between the papillary muscles and mitral annulus is restored by placing two 3-0 expanded polytetrafluoroethylene mattress sutures: one for the anterior papillary muscle at the 9–10 o'clock position (as defined by mid-anterior annulus to be 0 o'clock) on the mitral annulus, and the other for the posterior papillary muscle at the 5–6 o'clock position.

Key Words: Rheumatic mitral stenosis • Artificial chordae tendineae • Valve replacement • Oblique direction

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