Optimizing Exposure for Mitral Repair: Anterior Annulus–to–Leaflet Stitch Technique

Exposure of anatomic landmarks is key in mitral valve repair. We report a technique to improve exposure of the mitral valve posterior leaflet during video-assisted procedures. It consists of a traction stitch placed on the leaflet free edges after triangular resection and through the anterior left atrial wall close to the mitral annulus. Gentle traction on this suture pulls the posterior leaflet on the plane of the mitral annulus to improve exposure and to expedite the reconstruction.