A Simple Nonresectional Technique for Degenerative Mitral Regurgitation With a Very Large Posterior Leaflet: Chordal Foldoplasty

Leaflet resection with sliding valvuloplasty or additional chordal replacement is a standard technique for very large posterior leaflet prolapse. Regular chordal replacement without resection is simpler than those techniques. However, it may not reduce the leaflet height enough to avoid systolic anterior motion. In our technique, two pairs of neochordae are placed on the middle portion of the prolapsing scallop, which fixes the prolapse, reduces the functional height of the posterior leaflet, and blocks the leaflet tip from moving forward. This simple nonresectional technique can be easily performed with minimally invasive approaches. Postoperative echocardiography shows excellent leaflet motion and deep coaptation.