We present a case of a 67 yo man with breathlessness on exertion due to severe mitral valve (MV) regurgitation. We performed a MV repair via sternotomy. Neo-chords were fashioned to repair the flail /prolapsing posterior leaflet with the pre-made Chord-X 16mm loop system. A good result was obtained with no residual MV regurgitation and a good depth of leaflet coaptation (10mm). As a non-specialist mitral valve surgeon we have found that the Chord-X system of placing neo-chords allows a >90% repair rate for isolated posterior leaflet prolapse or flail. It simplifies the MV repair procedure in such cases, allowing multiple chords to be easily placed, and reducing the error rate of getting the wrong chordal length when creating multiple neo-chords. Most posterior leaflets require 16mm length ChordX whilst anterior leaflets require 20mm.
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