1. Artificial mitral valve chordae replacement made simple
David H Adams, MD, Alexander Kadner, MD, Raymond H Chen, MD, PhD 
The Annals of Thoracic Surgery 
Volume 71, Issue 4, Pages (April 2001)
DOI: /S (00)

2. Fig 1
(a) Placement of one or more simple Gore-Tex sutures in the papillary muscle head is easy to perform after posterior leaflet resection because of enhanced exposure. (b) Typical appearance of a myxomatous mitral valve after posterior leaflet quadrangular resection and sliding valvuloplasty. Poor leaflet apposition is present in all leaflet segments, and segmental anterior leaflet prolapse can be localized only by height comparison with the normal reference point (usually P1). (c) After ring annuloplasty symmetric leaflet apposition limits valve incompetence to the prolapsing anterior leaflet segment. (d) After annuloplasty both arms of the Gore-Tex suture are passed through the margin of the prolapsing segment. Optimal artificial chord height is determined by intermittently testing valve competency by injecting saline into the ventricle. (e) Completed repair with artificial chord in place. A symmetric line of apposition results in valve competence.
The Annals of Thoracic Surgery  , DOI: ( /S (00) )