The Imbrication Technique: An Alternative to the Sliding Leaflet Technique

Systolic anterior motion (SAM) represents a common and troublesome complication of mitral valve repair. The prevention of SAM has traditionally been based on the sliding leaflet technique, which involves resection of posterior leaflet tissue. However, this approach has not been universally adopted owing to its technical difficulty and inconsistent efficacy. We present an imbrication technique that avoids additional leaflet resection and achieves a reliable prevention of SAM. The approach has been successfully implemented in the treatment of 124 consecutive patients at high risk for SAM.