Three patients had chronic mitral regurgitation due to commissural cho
rda rupture with commissural prolapse. Two of them had myxomatous valv
e disease and 1 had fibroelastic deficiency. Characteristic intraopera
tive epicardial and transesophageal echocardiographic findings are dem
onstrated. A technique is proposed that involves creating a new commis
sure and avoiding annular plication by extended sliding plasty and rot
ating the posterior mitral leaflet.