The Journal of Thoracic and Cardiovascular Surgery, Vol 75, 870-876, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Replacement of ruptured chordae tendineae of the mitral valve with autologous pericardial chordae
EA Rittenhouse, CC Davis, SJ Wood and LR Sauvage
Severe mitral regurgitation owing to rupture of chordae tendineae has been
repaired in 10 patients by construction of new chordae from autologous
pericardium. The site of rupture was the posterior leaflet in eight
patients, the anterior leaflet in one patient, and both leaflets in one
patient. Cardiac catheterization demonstrated severe mitral regurgitation
(average 49%) and a left atrial V wave of 45 mm. Hg. The reconstruction was
carried out with pericardium rolled into a chorda with one end attached to
the appropriate papillary muscle and the other attached to the flail edge
of the mitral valve leaflet being repaired. One patient died on the seventh
postoperative day from pneumonia. The remaining nine patients are alive and
well (Functional Class I) from 6 months to 9 1/2 years (average 3 years)
following the operation. None requires anticoagulants.