Replacement of chordae tendineae using expanded polytetrafluoroethylene (ePTFE) sutures during mitral valve replacement in patients with severe mitral stenosis.

Since September 1991, 20 patients with mitral stenosis underwent mitral valve replacement and chordal replacement with expanded polytetrafluoroethylene (ePTFE) sutures. The continuity between the papillary muscles and the mitral annulus was maintained by four mattress sutures of ePTFE, which connected the stumps of the papillary muscle heads to the mitral annulus at the 2, 4, 8, and 10 o'clock positions. Low profile bileaflet prosthetic valves were inserted. There was no mortality either in-hospital or during follow-up. There was no valve related morbidity, such as valve structural failure, thromboembolism, anticoagulant related hemorrhage, prosthetic valve endocarditis, or posterior left ventricular rupture. The technique of replacing chordae tendineae is described in detail.