Politetrafluorene suture used as artificial mitral chord: mechanical properties and surgical implications

J Cardiovasc Surg (Torino). 2017 Dec;58(6):895-903. doi: 10.23736/S0021-9509.17.10065-0.

Abstract

Background: Novel surgical approach to repair degenerative mitral regurgitation such as transapical chordae tendineae replacement and "loop in loop" in loop techniques, need of artificial chordae longer than that used in the older techniques of chordae tendineae replacement. This difference in length has been reported as potential critical point for durability of artificial chordae. In the present paper we have investigated the elastic behavior of different diameter and length politetrafluorene (PTFE) suture threads as substitute of native chordae, to identify their reliability to use as long artificial chordae.

Methods: PTFE suture threads with different diameters were investigated in their mechanical properties at different length from 2 to 14 cm, by a servo hydraulic testing machine, to test the elastic properties of the sample in their use as mitral chordae substitutes.

Results: Our study shows that the chordae length is an important parameter that can change the performance of chordae itself. The analysis of elastic/properties of suture threads specimen, reveals that long PTFE chords have an optimal mechanical behavior in which elongation is accompanied by a safe elastic properties that make them well resistance during multiple tractions.

Conclusions: In conclusion the use of PTFE as an artificial chordae may represent a valid choice in case of insertion of artificial chordae with extra anatomic length.

MeSH terms

  • Biomechanical Phenomena
  • Chordae Tendineae / physiopathology
  • Chordae Tendineae / surgery*
  • Elastic Modulus
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis*
  • Humans
  • Materials Testing
  • Mitral Valve / physiopathology
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Polytetrafluoroethylene / chemistry*
  • Prosthesis Design
  • Prosthesis Failure
  • Suture Techniques / instrumentation*
  • Sutures*

Substances

  • Polytetrafluoroethylene