A: Chordae transposition from the posterior leaflet to the anterior leaflet. A—prolapsed segment of the anterior leaflet due to rupture chords; B—resection.

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A: Chordae transposition from the posterior leaflet to the anterior leaflet. A—prolapsed segment of the anterior leaflet due to rupture chords; B—resection of a localized segment of the posterior leaflet with its chords; C—flip over to the anterior leaflet and suturing of the posterior leaflet. B: Chordae shortening technique. A—trench created in the head of the papillary muscle; B and C—elongated chords are buried inside the trench; D—trench is closed. C: Repair of ruptured chords. A—prolapsed segment of the anterior leaflet due to ruptured chords; B—resection of a secondary chord; C—translation to the free margin. (Reproduced with permission from Edmunds LH. Cardiac Surgery in the Adult. New York: McGraw-Hill; 1997.) Source: Valvular Heart Diseases, Clinical Manual and Review of Transesophageal Echocardiography, 2e Citation: Mathew JP, Swaminathan M, Ayoub CM. Clinical Manual and Review of Transesophageal Echocardiography, 2e; 2010 Available at: http://accessanesthesiology.mhmedical.com/DownloadImage.aspx?image=/data/books/math2/math2_c008f007b.gif&sec=40110104&BookID=417&ChapterSecID=40109066&imagename= Accessed: November 10, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved

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