Summary
Sixty-five patients were treated for ruptured mitral valve chordae from January, 1976,
to December, 1981; 21 patients underwent valve reconstruction (group A) and 44 underwent
valve replacement (group B). Both groups had a mean age of 62 years with an overall
male: female ratio of 2 : 1. Eighty-one percent of group A and 73 % of group B presented
in clinical class III/IV (NYHA). Chordal rupture was spontaneous in 76% (group A)
and 61% (group B) respectively, with posterior leaflet chordal involvement in most
patients. The operative mortality was 6.8% (3 deaths) in group B with no early death
in group A (p < 0.001). More than 85% of both groups were in class I/II (NYHA) postoperatively.
The actuarial survival at 5 years was 85 % in group A and 78% in group B. No emboli
occurred in group A while an actuarial incidence of freedom from emboli of 76% at
5 years was observed in group B (p < 0.046). One patient (4.8%) in group A was reoperated
for failed valve repair. The patients with repaired valves were assessed by echocardiography.
The peak rates of dimension change of the left ventricular cavity were in the normal
range in all but 3 patients, while the left ventricular and end-diastolic dimensions
were significantly reduced (p < 0.005). We conclude that valve reconstruction provides
an improved functional result in patients with ruptured mitral chordae in addition
to an increased event-free survival.
Key words
Ruptured chordae tendinae - Mitral valve repair - Echocardiogram
