Preservation of anterior leaflet chordae tendineae during mitral valve replacement.

Preservation of anterior mitral leaflet papillary muscle attachments during mitral valve replacement was achieved in 20 patients by excising the central portion of the anterior leaflet and suturing the rim of leaflet tissue containing marginal chordae to the remaining edge of leaflet attached to the left atrium. This closure tacks the chordae to the fibrous trigones, opens the subvalvular area, and avoids a potentially thrombogenic or obstructive redundant leaflet ridge along the rim of an inserted valve. The technique is simple, safe, reproducible, and teachable.