Haircut mitral valve repair: posterior leaflet-plasty.

A 63-year-old man presented with symptomatic severe mitral regurgitat ion. Both trans-esophageal 3-D echocardiography and operative linear measurements showed a 25 mm long A2 anterior leaflet with a very wide (23 mm) prolapsing 30 mm long P2 posterior mid-scallop (Figure 1A,B). P1 and P3 were diminutive in height and width (Figure 2). A ‘haircut’ posterior leaflet-plasty was done to maintain leaflet-annular integrity, shorten and reduce the prolapsing P2 and preserve adequate tissue for coaptation.