Preservation of anterior and posterior leaflet in mitral valve replacement with a tilting-disc valve.

An operative technique for mitral valve replacement with preservation of chordae tendineae to both the anterior and posterior leaflets is described. The anterior mitral valve leaflet is completely detached from the annulus and divided into three to four islands of tissue, each with attached chordae tendineae. These islands are transposed under the posterior leaflet and secured with 4-0 polypropylene sutures. The posterior leaflet is completely preserved with no division or manipulation. This technique allows safe implantation of tilting-disc or bileaflet prostheses with excellent preservation of left ventricular function.