Mitral regurgitation due to ruptured chordae tendineae. Early and late results of valve repair

T. A. Orszulak, Hartzell V Schaff, G. K. Danielson, J. M. Piehler, J. R. Pluth, R. L. Frye, D. C. McGoon, L. R. Elveback

Research output: Contribution to journalArticle

61 Scopus citations

Abstract

From 1958 through 1980, 131 patients had repair of ruptured chordae tendineae of the mitral valve; 62% were men. Ages ranged from 5 to 70 years (median 57). Chordae to the anterior mitral leaflet were ruptured in 44 patients (34%), to the posterior mitral leaflet in 85 (65%), and to both leaflets in two patients (1%). The mitral valve was repaired by leaflet plication without resection in 116 patients, plication after wedge resection of the unsupported leaflet in six, Ivalon buttress of the posteior leaflet in three, resuspension of chordae in two, and annuloplasty alone in the remaining four. Mitral valve annuloplasty was performed in addition to leaflet repair in 115 patients (88%). Operative (<30 days) mortality was 6.1%. Survival rate of patients dismissed from the hospital was 92% at 5 years and 73% at 10 years. There were no differences in late survival or risk of reoperation for recurrent or residual mitral insufficiency between patients with ruptured chordae to the anterior leaflet and those with ruptured chordae to the posterior leaflet. Survival was significantly better for the group with repair than it was for a group that underwent mitral valve replacement for ruptured chordae during this same time interval (5 year survival rate, 92% versus 72%, p<0.003). The incidence of thromboembolism after repair was 1.8 episodes/100 patient-years compared with 8.0 episodes/100 patient-years after replacement. Our data indicate that valvuloplasty is the procedure of choice for most patients with mitral regurgitation owing to ruptured chordae tendineae, including selected patients with ruptured chordae to the anterior leaflet.

Original languageEnglish (US)
Pages (from-to)491-498
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume89
Issue number4
StatePublished - 1985

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Fingerprint Dive into the research topics of 'Mitral regurgitation due to ruptured chordae tendineae. Early and late results of valve repair'. Together they form a unique fingerprint.

  • Cite this

    Orszulak, T. A., Schaff, H. V., Danielson, G. K., Piehler, J. M., Pluth, J. R., Frye, R. L., McGoon, D. C., & Elveback, L. R. (1985). Mitral regurgitation due to ruptured chordae tendineae. Early and late results of valve repair. Journal of Thoracic and Cardiovascular Surgery, 89(4), 491-498.