Butterfly technique in mitral valve repair.

Degenerative mitral regurgitation due to posterior leaflet prolapse is often associated with tissue redundancy in the leaflet height and free margin of the prolapsing segment. The butterfly technique has been introduced for focal resection to precisely control the leaflet height without annular plication. This technique is indicated for a high prolapsing leaflet, greater than 20 mm. With intraoperative measurement of leaflet heights and ink dot marking as a depth indicator, the butterfly technique can be safely performed in most high posterior leaflet prolapse cases, without increasing the risk of systolic anterior motion.