Surgical techniques:
Surgery was performed with use of cardiopulmonary bypass using cold crystalloid cardioplegic arrest. Bicaval cannulation was used and exposition of the mitral valve was achieved via a bi-atrial vertical transseptal incision or via Waterston’s incision. Moderate hypothermia (32–34°C) was used. In the repair group, the valve was corrected using the “respect” technique by insertion of 2–5 artificial Gore-Tex Neo-Chordae to re-suspend the prolapsing segments in the presence of chordal rupture or elongation, in addition to a supplement of remodeling annuloplasty. Neo-Chordae were used via a premeasured moveable loop technique (12) with ventricular placed knots. In forms of regurgitation not associated with chordal rupture or elongation, correction of MV was performed only by remodeling annuloplasty. The rings used were Carpentier Edwards Physio II Annuloplasty ring or Sorin Memo 3D ReChord Mitral Valve Annuloplasty ring. In select cases, cleft sutures were placed.