Yano Mitsuhiro, Sakaguchi Syuuhei, Furukawa Kohji, Nakamura Eisaku
Department of Cardiovascular Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan
Department of Cardiovascular Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan.
Interact Cardiovasc Thorac Surg. 2015 Aug;21(2):240-2. doi: 10.1093/icvts/ivv129. Epub 2015 May 16.
The use of expanded polytetrafluoroethylene (ePTFE) sutures for the correction of mitral valve prolapse has become a standardized procedure. Adjustment of neochordal length is crucial to the efficacy of this technique. Various methods have been described for this purpose; however, the fine adjustment of neochordal length is technically challenging. We describe a simple and effective technique for the implantation of neochordae, which we have termed the 'adjustable slip knot technique'. The first step of this technique is reinforcement of the papillary muscle by a Teflon pledget with or without polytetrafluoroethylene (CV-4) loops. The second step is the formation of a neochordal loop by introducing an ePTFE suture between the affected mitral leaflet and the papillary muscle or ePTFE loops. The third step is the adjustment of the length of neochordae. The formation of a slip knot in one arm of the ePTFE suture is the pivot of this technique. The neochordal loop can be constricted by the application of tension to one arm of the suture. We applied this technique in 5 patients with satisfactory results.
使用膨体聚四氟乙烯（ePTFE）缝线矫正二尖瓣脱垂已成为一种标准化手术。新腱索长度的调整对该技术的疗效至关重要。为此已描述了多种方法；然而，新腱索长度的精确调整在技术上具有挑战性。我们描述了一种简单有效的新腱索植入技术，我们称之为“可调滑结技术”。该技术的第一步是用带或不带聚四氟乙烯（CV - 4）环的特氟龙垫片加强乳头肌。第二步是通过在受影响的二尖瓣叶与乳头肌之间引入ePTFE缝线或ePTFE环来形成新腱索环。第三步是调整新腱索的长度。在ePTFE缝线的一个臂上形成滑结是该技术的关键。通过对缝线的一个臂施加张力可收紧新腱索环。我们将该技术应用于5例患者，效果满意。
