Chordal translocation for ischemic mitral regurgitation may ameliorate tethering of the posterior and anterior mitral leaflets

Abstract

Compared with chordal cutting alone, chordal translocation improved both the left ventricle function and mitral geometry in a canine model of acute ischemic mitral regurgitation. Chordal translocation may be beneficial because it ameliorates the tethering of both the anterior and posterior leaflets, which is aggravated by mitral annuloplasty alone.

Surgical Treatment for Functional Mitral Regurgitation

“…38,42,43 This method is in parallel with the natural structure and function of the mitral valve, but it is a slightly more complex procedure and might require some experience when conducting it, especially in order to prevent aortic regurgitation. Langer and Schäfers reported the anterior relocation of each papillary tip without cutting the secondary chodae.…”

“…Masuyama et al showed that chordal translocation, which pulls PM tips anteriorly (ie, the direction of the secondary chordate and the "stress line" toward the mid-anterior annulus), improved tethering of the posterior leaflet (Figure 4). 42,43 Further investigation is warranted experimentally and clinically.…”

Surgical Ventricular Restoration for Ischemic Cardiomyopathy with Functional Mitral Regurgitation

“…For these patients, functional MR was relieved by mitral valve plasty (MVP) including mitral annuloplasty (MAP) with an undersized flexible annuloplasty ring 38) , chordal cutting of the basal chordae 39,40) , papillary muscle approximation [41][42][43][44] , and chordal translocation 45) . We usually repair functional MR using MAP with a semi-rigid ring, and/or chordal cutting, and/or papillary muscle approximation.…”

Quantification of mitral valve apparatus by three-dimensional transesophageal echocardiography: in vitro validation study comparing two different analysis systems

“…3). With Real View Ò , both the mitral annulus and leaflets are reconstructed in 18 cross-sectional radial planes spaced 10°apart [19,[24][25][26][27]. With MVQ Ò , the annulus is marked in radial planes as with Real View Ò , and leaflets are traced on sections parallel to the anterior-posterior axis of the annulus.…”