Midterm outcomes of chordal cutting in combination with downsized ring annuloplasty for ischemic mitral regurgitation

Abstract

Purpose: We describe midterm outcomes after division of secondary chords (chordal cutting)combined with downsized ring annuloplasty for ischemic mitral regurgitation (IMR). Methods: We compared the clinical outcomes in patients who underwent chordal cuttingwith downsized ring annuloplasty (CC-group, n = 15) and those who underwent conventionalring annuloplasty only (Conventional-group, n = 35) for IMR. Follow-up was complete inall patients. The median follow-up time was 4.1 years. Results: Thirty-day mortality was 0% in CC-group and 20% in Conventional-group. Theoverall survival rate at 5-year was 80.8% ± 12.6% in CC-group and 61.7% ± 8.4% inConventional-group (Log-rank, p = 0.145). The freedom rate from valve-related events at5 year was 84.6% ± 10.0% in CC-group and 65.3% ± 10.1% in Conventional-group (Logrank,p = 0.213). Recurrence of severe mitral regurgitation was revealed in 3 patients ofCC-group. Preoperative tenting height was the significant predictor of mitral regurgitationrecurrence. In CC-group, the mean left ventricular ejection fraction was 38.0% ± 14.0%,which was similar to the preoperative value of 40.0% ± 13.2% (p = 0.349).Conclusions: Chordal cutting with downsized ring annuloplasty for IMR is a simple methodand provides satisfactory early outcomes. However, it carries with high recurrence of MRespecially for patients with high tenting height.