الفهرس 
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Abstract
SUMMARY
Reparative procedures for pathological conditions of the mitral valve have become standard surgical therapy for mitral regurgitation in the current era.
Mitral valve repair is the treatment of choice in patients with mitral insufficiency. Mechanical valves, even functioning perfectly, are less efficient hemodynamically than native mitral valve and also have attendant morbidity from thromboembolism, anticoagulant related hemorrhage and endocarditis.
The principles of mitral valve repair have evolved from experience with mitral valve anatomy and function as well as with all four underlying etiologies of mitral regurgitation: Rheumatic, endocarditis, ischemic and myoxmatous mitral valve disease.
Regardless of the type of the valvular dysfunction all patients with chronic mitral regurgitation display some degree of annular dilatation and benefit from a complete Remodeling annuloplasty.
Remodeling mitral annuloplasty is an essential component of repair of the mitral valve for different types of pathologies as it achieves all the principles of mitral valve repair. Good exposure and proper assessment of the mitral valve is essential for successful mitral valve repair.
Techniques of mitral annuloplasty include suture annuloplasty and ring annuloplasty.
Suture annuloplasty techniques are grouped into 2 main types according to the site of the procedure:
Commissural area (ex. Kay or Reed suture annuloplasty).
Mural portion of the annulus (ex. mitral plication, Frater, or Posterior Segmental plication suture annuloplasty)
Ring annuloplasty, nowadays, is the final step of the basic mitral valve repair technique. There are many different types of annuloplasty rings:
Prosthetic which maybe complete or incomplete C-rings, totally flexible, totally rigid or semi flexible rings.
Biological (ex. Degradable or pericardial rings).
Although, there is a wide range of annuloplasty systems available, the most important structural characteristics of an ideal annuloplasty system are not as yet determined.
Superiorities both of flexible to rigid, and partial to complete ring are difficult to demonstrate with certainty. Therefore, the choice of annuloplasty device depends on the surgeon preference and the valve pathology.