Repair of commissural prolapse by extended leaflet sliding.

Three patients had chronic mitral regurgitation due to commissural chorda rupture with commissural prolapse. Two of them had myxomatous valve disease and 1 had fibroelastic deficiency. Characteristic intraoperative epicardial and transesophageal echocardiographic findings are demonstrated. A technique is proposed that involves creating a new commissure and avoiding annular plication by extended sliding plasty and rotating the posterior mitral leaflet.