Posterior Leaflet Detachment, Augmentation, and Reconstruction for Treatment of Functional Mitral Valve Regurgitation.

Functional mitral regurgitation caused posterior leaflet tethering and central malcoaptation treated utilizing undersized annuloplasty alone is associated with high rates of early failure. We report the technical steps necessary for near complete near complete detachment, augmentation and reconstruction of a thin and diminutive posterior mitral leaflet to reproducibly re-establish normal mitral leaflet coaptation and eliminate functional MR.