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It’S More Than “Just” A Triangular Resection
Ali Hage, MD, MPH, Daniel Burns, Tarek Malas, Marc Gillinov;
Cleveland Clinic, Cleveland, OH, USA

BACKGROUND: Isolated segmental prolapse of the mitral valve (MV), most commonly that of the P2 segment, is one of the most common etiologies of degenerative mitral regurgitation (MR). When faced with such a case, the most frequently used repair technique includes an annuloplasty (either a complete or an incomplete ring) in addition to either a resection (“resect” technique) or neochords (“respect” technique).
METHODS: Here we will focus on the isolated P2 triangular resection, how we select it, and its many variations.
RESULTS: In this report, we described the classical triangular resection (i.e., the isosceles form), the role of folding plication (when the sides of the triangle are not of equal heights), the utility of a focal annular plication, the relevance of residual clefts, and the role of adding a neochord to the resection.
CONCLUSIONS: The most encountered degenerative form of MR that the surgeon will face will consist of P2 prolapse which will require “just” a triangular resection (or in fact, as we saw, more than “just” a resection).

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