In the anterior repair an atriotomy was performed first, the artificial chordae was placed in the usual manner, and then a flexible annular ring was tied on the mitral annulus. An aortotomy was performed to expose the native chordae and to calibrate the length of the artificial chordae that were locked but not tied down. The mitral valve was inspected through the atriotomy while saline water was injected through the aortotomy in the left ventricle. The chordae were tied from the aortotomy and the incisions closed in the usual fashion. In the posterior leaflet prolapse, repair was done.
