Quadrangular resection for repair of posterior leaflet prolapse

Quadrangular resection is the gold standard technique with thirty years results for correction of posterior leaflet prolapse. In most cases, resection removes the prolapsed area, which will correct the dysfunction. The posterior leaflet is repaired with either plication of the annulus or with sliding plasty in the case of excess of tissue as seen in Barlow's diseases, to minimize the risks of systolic anterior motion (SAM). After a quadrangular resection, the insertion of a ring completes the repair.