Repair of commissural prolapse associated with chordal rupture may represent a challenging problem for the cardiac surgeon. The case of a patient with chronic mitral regurgitation and prolapse of the posterior commissural area associated with chordal rupture is presented. A technique was proposed that involved partial resection of the degenerative leaflet segment, plication of the posterior annulus and chordal transfer to create a neocommissure. An analysis of the options available for surgical treatment of commissural prolapse is included.
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