Seven-year experience with chordal replacement with expanded polytetrafluoroethylene in floppy mitral valve.

Among 106 patients operated on for implantation of artificial mitral chordae (expanded polytetrafluoroethylene), usually associated with other traditional procedures, 82 had degenerative valve disease. Two of them had the valve replaced during the same operation because of residual regurgitation, and one patient died (1.3%) of respiratory insufficiency. Seventy-nine patients left the hospital and were followed up to 84 months. No late deaths and only one valve-related complication were reported. This occurred in a patient who required reoperation after 18 months for sudden recurrence of mitral regurgitation caused by the rupture of natural chordae, which had been shortened during the first procedure, whereas the artificial chordae had retained their function. The clinical experience confirms positive experimental data, because this technique was reliable with lasting results. Application of artificial chordae, associated with other traditional techniques, is useful to improve the results and to extend the indications for mitral valve repair.