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A new method for the adjustment of neochordal length: the adjustable slip knot technique.

Abstract
The use of expanded polytetrafluoroethylene (ePTFE) sutures for the correction of mitral valve prolapse has become a standardized procedure. Adjustment of neochordal length is crucial to the efficacy of this technique. Various methods have been described for this purpose; however, the fine adjustment of neochordal length is technically challenging. We describe a simple and effective technique for the implantation of neochordae, which we have termed the 'adjustable slip knot technique'. The first step of this technique is reinforcement of the papillary muscle by a Teflon pledget with or without polytetrafluoroethylene (CV-4) loops. The second step is the formation of a neochordal loop by introducing an ePTFE suture between the affected mitral leaflet and the papillary muscle or ePTFE loops. The third step is the adjustment of the length of neochordae. The formation of a slip knot in one arm of the ePTFE suture is the pivot of this technique. The neochordal loop can be constricted by the application of tension to one arm of the suture. We applied this technique in 5 patients with satisfactory results.
AuthorsMitsuhiro Yano, Syuuhei Sakaguchi, Kohji Furukawa, Eisaku Nakamura
JournalInteractive cardiovascular and thoracic surgery (Interact Cardiovasc Thorac Surg) Vol. 21 Issue 2 Pg. 240-2 (Aug 2015) ISSN: 1569-9285 [Electronic] England
PMID25980773 (Publication Type: Case Reports, Journal Article)
Copyright© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Chemical References
  • Biocompatible Materials
  • Polytetrafluoroethylene
Topics
  • Adult
  • Aged
  • Biocompatible Materials
  • Chordae Tendineae (surgery)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve (surgery)
  • Mitral Valve Insufficiency (surgery)
  • Mitral Valve Prolapse (surgery)
  • Papillary Muscles (surgery)
  • Polytetrafluoroethylene
  • Suture Techniques

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