Complex Mitral Valve Repair: Triangular Resection, Annuloplasty, and Chordal Replacement With Premeasured Loops

The authors present a repair for severe mitral regurgitation that demonstrates the effectiveness and reproducibility of the placement of preformed neochords. The procedure was performed in a 64-year-old asymptomatic patient with severe mitral regurgitation due to bivalvar prolapse with Barlow’s disease.A complex mitral valvular plastic was performed, with triangular resection of segment P2, closure of the defect, placement of premeasured loops in the anterior leaflet, and annuloplasty with semirigid ring. The patient did well, without complications. No transfusion or inotropic drugs were required. He stayed in the intensive care unit for 24 hours and was discharged on the fifth day after surgery.Complex mitral repair with premeasured loops should be included amongst traditional techniques since it is an undeniably effective, reliable, and highly reproducible method, even in adverse conditions. The rising interest in this technique has prompted the authors to conduct further evaluations to assess its medium- and long-term results.