Artificial chordal replacement for complex mitral valve repair

The development of mitral valve repair is one of the all-time success stories in medicine. In the 1960s and 1970s, mitral valve replacement was the highest risk adult cardiac procedure in most centers, with operative mortalities approaching 20–30% in many categories. Based on innovation from many sources, reparative methods were refined and developed, and Carpentier’s lecture before the American Association for Thoracic Surgery in 1983 brought together the techniques of ring annuloplasty, leaflet reconstruction, and chordal shortening/ transfer into a unified approach. Carpentier’s contributions stimulated great interest in repair, and progress continued on many fronts.