Is an anterior mitral leaflet prolapse still a challenge?

Quadrangular resection is the gold standard in the treatment of posterior leaflet prolapse. Anterior leaflet prolapse has been considered a more challenging problem; several techniques are available to treat it, all with the same goal mitral valve competency. Nowadays, good long-term results are reported, similar to those for posterior leaflet prolapse. Certain improvements may explain these results, especially improvements in transesophageal echocardiography (including three-dimensional echocardiography), which allow the detection of atypical mitral regurgitation and its mechanism. (C) 2010 Elsevier Masson SAS. All rights reserved.