Modified preservation of all annular-papillary continuity in replacement of the calcified mitral valve

The technique described here is a modification of the mitral valve replacement with preservation of chordae tendineae for calcified mitral stenosis. After commissurotomy, the middle portion of the anterior leaflet is excised to get two parts with accessible chordal insertion. Each thickened and calcified segment is debrided by means of an ultrasonic tool and then attached to the mural leaflet. Finally mitral valve replacement is carried out. This procedure will extend surgical indication of chordae-sparing methods in mitral valve replacement for mitral stenosis.