Leaflet repair techniques in mitral valve reconstruction

Recently, there has been tremendous development in mitral valve repair, especially in imaging modalities, minimally invasive approaches and surgical techniques. Among various surgical techniques, leaflet techniques have also advanced for treatment of different types of mitral valve diseases. The optimal leaflet technique depends on the involvement of anterior or posterior leaflet, aetiology of the disease and the usage of surgical approach. In degenerative disease for posterior leaflet prolapse, the current trends are from classical quadrangular resection to limited triangular resection. Development of techniques like peeling and pericardial leaflet augmentation has made mitral valve repair feasible in rheumatic heart disease. Similarly, with better understanding of pathophysiology of ischemic mitral regurgitation, the new techniques involving leaflets and subvalvular apparatus have also progressed for more stable and durable repair. In this review, various leaflet repair techniques, which are applicable to various types of functional classification for different aetiology, have been described in detail. © 2017, Indian Association of Cardiovascular-Thoracic Surgeons.