On-X Chord-X Series, Instructions For Use Manual

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Caution: Be aware if 2 strands are cut, there will be a free-floating piece
of suture that will need to be retrieved.
2. Removing extra suture strands from the Chord-X
™
Suture System
Adjustable prosthesis version:
Remove undesired suture strand by cutting a single chordal suture strand
and discard. ( See Figure 4 )
Caution: Be aware if 2 strands are cut, there will be a free-floating piece
of suture that will need to be retrieved.
6.4. Papillary Suture Placement:
Place the Chord-X ™ Pre-Measured Loops or the Chord-X ™ Suture System
prosthesis papillary suture with attached needle through the papillary
muscle, with a pledget placed on each side of the muscle. One pledget is
pre-attached to the prosthesis. The second pledget is provided in the case.
The papillary suture is then tied using at least seven (7) flat square throws.
Additional throws may be necessary depending on surgical circumstances.
( See Figure 5 )
6.5. Leaflet Loop Placement:
1. Chord-X
™
Pre-Measured Loops prosthesis version leaflet placement
and knot tying:
Once the suture has been anchored to the papillary muscle, pass each
required chordal pre-measured suture loop through the free edge of the
prolapsed leaflet, taking care to not entrap native chordae as the Chord-X
™
Pre-Measured Loops are individually positioned and tied.
The two suture strands of each Chord-X
™
chordal Loops are run through the
free margin of the leaflet, then tied.
Tie the Chord-X
™
Pre-Measured Loop ends using at least seven (7) flat square
throws. Continue placement of the remaining Chord-X ™ Pre-Measured
Loops as needed to complete artificial chordal replacement, tying each one
as described. (
See Figure 6
)