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Two surgical techniques, leaflet resection and leaflet preservation, are widely used for mitral valve repair in severe mitral regurgitation due to posterior mitral leaflet prolapse. However, which technique is superior remains unclear. The leaflet resection technique may affect the postoperative mitral valve function differently from the leaflet preservation technique because it causes anatomical alterations in the corrected leaflet. We aimed to evaluate the effect of the leaflet resection technique on mitral valve mobility, compared with that of the leaflet preservation technique.

Forty-one patients underwent mitral valve repair for P2 prolapse. Among them, 27 underwent leaflet preservation and 14 underwent leaflet resection. We examined the effects of the leaflet resection technique on the mitral valve mobility.

Postoperatively, the mobility of the corrected leaflet was significantly decreased in the leaflet resection group (leaflet preservation: 35.1 ± 13.8 vs. leaflet resection: 22.7 ± 13.7°, p = 0.009). Particularly, the maximum closed angle was significantly decreased (leaflet preservation: 29.1 ± 11.4° vs. leaflet resection: 40.7 ± 12.0°, p = 0.004). Therefore, the closing motion of the resected leaflet was more restricted than its opening motion. Mitral valve function, including mitral valve area, and peak and mean transmitral pressure gradients were comparable in both groups.

Although there were no differences in the mitral valve function, the leaflet preservation technique may be more effective than the leaflet resection technique at preserving the corrected leaflet mobility.