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European Journal of Echocardiography 2008 9(1):54-55; doi:10.1016/j.euje.2006.08.009
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2006. For permissions please email: journals.permissions@oxfordjournals.org.

Echocardiographic evaluation of mitral tethering for ‘chordal cutting’ procedure

U. Da Col, I. Di Bella*, G. Bardelli, A. Affronti, G. Koukoulis, S. Pasquino and T. Ragni

Department of Cardiac Surgery, Silvestrini Hospital, S. Andrea delle Fratte, 06100 Perugia, Italy

Received 20 March 2006; accepted after revision 22 August 2006; online publish-ahead-of-print 10 October 2006.

* Corresponding author. Tel: +39 75 5782213; fax: +39 75 5782214. E-mail address: isidorodibella{at}yahoo.it


  Abstract

‘Chordal cutting’ is a recently proposed surgical option for the treatment of functional mitral regurgitation due to leaflet tethering. With this technique the surgeon sections second order chordae, restores leaflet's convexity towards the left atrium and eliminates mitral incompetence. Preoperative assessment of tethering mechanism, degree of leaflet distortion, surface of coaptation, annular dilation, origin and quantification of valve incompetence by echocardiographic means is essential in indicating this surgical option. Intraoperative transesophageal evaluation is crucial to assess the morphology and the absence or degree of residual incompetence after procedure.

Keywords: Mitral incompetence; Tethering; Mitral valve repair


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