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Posterior Leaflet: In the posterior leaflet a quadrangular excision of the sector involved in the prolapse is done. This may be up to 15-20 per cent of the leaflet. The remaining pat of the posterior. leaflet is mobilized by resecting some adjacent second and tertiary chordae. The resulting gap in posterior leaflet is bridged by a horizontal pledgetted mattress suture (compression suture). The leaflet margins are then sutured with simple prolene sutures. If wider cluadrangular excision is needed, a sliding plasty is done detaching the posterior leaflet from the annulus to the desired length and suturing back to make allowance for the quadrangular excision. The leaflet margins are sutured with interrupted prolene sutures.
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