Mitral Valve Subvalvular Apparatus Repair with Artificial Neochords Application

Degenerative mitral valve (МV) disease is a common disorder affecting around 2% of the population (Enriquez-Sarano M et al., 2009). The most common ending in patients with degenerative valve disease is leaflet rolapsed due to elongation or rupture of the chordal apparatus, resulting in varying degrees of МV regurgitation due to leaflet malcoaptation during ventricular contraction. The emphasis of clinical decision-making in patients with degenerative disease centres around the severity of regurgitation and its impact on symptom status, ventricular function and dimension, the sequelae of systolic flow reversal such as atrial dilatation/fibrillation and secondary pulmonary hypertension (PH), and the risk of sudden death (1-4). Current standard of care for MV rolapsed with severe mitral regurgitation (MR) is surgical MV repair (Adams et al., 2010). Implantation of neo-chordae with the use of expanded polytetrafluoroethylene (ePTFE) sutures (Gore Associates, Flagstaff, AZ, USA) has since its introduction into clinical practice by Frater et al. proven to be a valuable technique for contemporary MV repair. Chordal replacement enables preservation of native valve anatomy, physiological leaflet motion and creation of large mitral orifice area. Furthermore, it has contributed to the reparability independent of valve complexity (Seeburger et al., 2007).