Key result
Surgical repair of anterior mitral leaflet prolapse requires flexible, lesion-specific techniques for safe outcomes.
Highlights that anterior mitral leaflet prolapse, often considered beyond repair, can be safely repaired using a tailored surgical approach.
May support repair over replacement for anterior mitral leaflet prolapse; leaves open prospective validation of technique selection.
Myxomatous disease is the leading cause of mitral valve regurgitation in the developed world. Although posterior mitral leaflet (PML) prolapse is the most common cause of regurgitation and of repair, lesions of the anterior mitral leaflet (AML) are often considered beyond the possibilities of repair. The surgical anatomy and pathology of the AML and a precise terminology for the location of the lesions are described. The surgical maneuvers for commissural prolapse, chordal shortening, chordal replacement, leaflet resection, and annuloplasty are also described. The advantages and limitations of each maneuver are discussed. It is concluded that a flexible approach to the repair of the AML is necessary to adapt the best technique for each type of lesion. No particular technique can be applied systematically to all lesions. It is the author's contention that the majority of AML lesions can be repaired safely.
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Carlos M.G. Durán (2010) conducted a review in Anterior mitral leaflet prolapse. Surgical repair techniques was evaluated. Surgical repair of anterior mitral leaflet prolapse requires a flexible approach adapting various techniques to specific lesions, allowing the majority of lesions to be repaired safely.
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