Mitral insufficiency ring is typically secured to the annulus, or opening of the mitral valve, to provide additional structural support. In some cases, the "double orifice" (or 'Alfieri') technique for mitral valve repair, the opening of the mitral valve is sewn closed in the middle, leaving the two ends still able to open. This ensures that the mitral valve closes when the left ventricle pumps blood, yet allows the mitral valve to open at the two ends to fill the left ventricle with blood before it pumps. In general, mitral valve surgery requires "open-heart" surgery in which the heart is arrested and
Mitral valve the left ventricle. It has two leaflets (or 'cusps'), an anteromedial leaflet, and a posterolateral leaftlet. The opening of the mitral valve is surrounded by a fibrous ring known as the "mitral annulus". The anterior cusp covers approximately two-thirds of the valve (imagine a crescent moon within the circle, where the crescent represents the posterior cusp). Although the anterior leaflet takes up a larger part of the ring and rises higher, the posterior leaflet has a larger surface area. The valve leaflets are prevented from prolapsing into the left atrium by the action of chordae tendineae. The chordae tendineae are