Simple Height Reduction of the Posterior Leaflet in Robotic Mitral Annuloplasty

Systolic anterior motion is occasionally encountered during mitral valve repair using neochordal reconstruction for mitral regurgitation owing to large posterior leaflet prolapse. In cases with a redundant posterior leaflet, the risk of systolic anterior motion increases if the redundant posterior leaflet is unresected to decrease the leaflet height. The posterior leaflet was fixed at the anterior annulus, cut near the posterior annulus, and resected into a spindle shape. The excised part of the posterior leaflet was subsequently closed with a continuous suture. Herein, we report our simple height reduction technique of the posterior leaflet, the "curtain technique," performed in robotic surgery.