Monocuspidalisation of the mitral valve can be a solution for ischemic mitral regurgitation

Mitral valve repair is the preferred treatment for patients with mitral valve regurgitation (MR); however almost one third of all diseased mitral valves cannot be repaired (1). This ratio is even worse in patients with ischemic MR (2). Ischemia and resultant segmental or global left ventricle dilatation results in restriction of posterior leaflet motion. Tethering of the posterior leaflet (Type IIIb MR) makes it unavailable for cooptation with the anterior leaflet in the absence of structural damage to the valve (3).