MITRAL-VALVE DYSFUNCTION RESULTING FROM THICKENING AND STIFFENING OF ARTIFICIAL MITRAL-VALVE CHORDAE

Citation
Y. Kobayashi et al., MITRAL-VALVE DYSFUNCTION RESULTING FROM THICKENING AND STIFFENING OF ARTIFICIAL MITRAL-VALVE CHORDAE, Circulation, 94(9), 1996, pp. 129-132
Citations number
14
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System",Hematology
Journal title
ISSN journal
0009-7322
Volume
94
Issue
9
Year of publication
1996
Supplement
S
Pages
129 - 132
Database
ISI
SICI code
0009-7322(1996)94:9<129:MDRFTA>2.0.ZU;2-#
Abstract
Background There is little information about changes in mitral valve f unction caused by thickening and stiffening of artificial chordae duri ng follow-up. Using serial echocardiographic examination, we evaluated thickening and stiffening of artificial chordae and the effect of tho se changes on mitral valve function. Methods and Results Between Novem ber 1986 and November 1993, 40 patients underwent mitral valve repair with artificial chordae using glutaraldehyde-tanned xenograft pericard ium (GTXP) or polytetrafluoroethylene suture (PTFE). Seven GTXP patien ts and 20 PTFE patients underwent serial echocardiographic examination after surgery and were included in the final analysis. Thickening and stiffening of the artificial chordae were classified according to ech ocardiographic changes after surgery: grade 1, no change; grade 2, thi ckening and/or stiffening without impairment of the motion of the mitr al valve leaflet; and grade 3, thickening and stiffening that impaired motion of the mitral valve leaflet. The mean follow-ups in patients w ith GTXP and PTFE were 6.0 and 3.6 years, respectively. During follow- up, there were 2 GTXP patients with grade 2 thickening and stiffening and 4 patients with grade 3. There were 6 PTFE patients with grade 2 t hickening and stiffening and 2 patients with grade 3. Grade 3 occurred earlier in GTXP than in PTFE patients (P<.05). Mitral valve area in G TXP patients decreased from 2.5+/-0.4 to 2.1+/-0.3 cm(2) (P<.05); howe ver, mitral valve area in PTFE patients showed no significant change d uring follow-up (2.1+/-0.4 to 2.0+/-0.4 cm(2), P=NS). Conclusions Alth ough mitral valve repair with artificial chordae is useful, more atten tion should be paid to mitral valve function resulting from thickening and stiffening of artificial chordae.