Mitral valve repair and the anterior leaflet

Mitral valve repair with annuloplasty has become a widely accepted technique for correction of posterior leaflet mitral valve pathology. Advantages over mitral valve replacement include improved hemodynamic performance and improved ventricular function. Although repairs of the anterior leaflet met with less success initially, recent reports have emphasized the safety and effectiveness of chordal shortening, chordal transposition, and chordal replacement in treating disease of the anterior leaflet. Isolated annuloplasty and creation of double orifice mitral valves show promise for the treatment of mitral insufficiency in conjunction with heart failure and with other complex surgical procedures.