Chordal-sparing mitral valve replacement: pitfalls and techniques to prevent complications

When feasible, mitral valve repair is the usual treatment of choice for correction of chronic mitral insufficiency. When valve replacement is required, chordal sparing is the preferred technique. Many investigators have pointed out the merits of preserving the subvalvular apparatus during mitral valve replacement. However, many surgeons hesitate to perform chordal-sparing mitral valve replacement because of its technical complexity and potential interference with mechanical valve leaflet motion. We present a modified technique of chordal-sparing mitral valve replacement to avoid these problems.