Use of extended polytetrafluoroethylene (ePTFE) chordae to re-establish annular-papillary connection after mitral valve excision.

Preserving mitral annular-papillary muscle continuity during mitral valve replacement improves left ventricular function and may help prevent ventricular rupture. In patients with severe rheumatic or myxomatous mitral valve involvement, retaining native chordae may not be possible. We describe a technique to recreate the papillary muscle-mitral annular continuity with ePTFE sutures when excision of a portion or all of the subvalvular apparatus is required.