Early outcomes of transection of secondary chordae with downsized ring annuloplasty in low recurrence risk severe ischemic mitral regurgitation

Abstract

Background: Relying solely on restrictive annuloplasty for the repair of ischemic mitral regurgitation is associated with an unacceptable rate of recurrence. Transection of secondary chordae as an adjunctive procedure has been proposed to improve results.
Patient and methods: This is a prospective observational study including 20 patients who underwent mitral repair using downsized annuloplasty ring and transection of the secondary chordae, at the time of CABG at the Cardiothoracic Surgery Department of Cairo University Hospitals through the period between March 2016 and October 2018. The primary outcome being examined was the recurrence of significant mitral regurgitation at 6 months postoperatively. Secondary outcomes included coaptation length and ejection fraction.
Results: The mean age was 57.5 ± 6.9 years. The mean ejection fraction was 45.1 ± 11%. There was one early mortality (5%). At 6 months postoperatively, there was no incidence of recurrence of significant mitral regurgitation. Coaptation length was quite satisfactory (7.2 ± 0.67 mm).
Conclusion: Transection of secondary chordae is a safe and simple option. It may be beneficial when performed in combination with downsized ring annuloplasty in patients with low-risk ischemic mitral regurgitation.