Five patients with abnormalities of the chordae tendineae of the posterior (mural) cusp of the mitral valve have been treated by plication of the cusp, annulus, and atrium in continuity (modified McGoon valvoplasty). They had acute symptoms with physical signs characterized by sinus rhythm and an apical pansystolic murmur radiating to the base of the heart. Investigation showed high left atrial systolic pressures in small atria. Apart from one patient who died of cerebral air embolism with a good haemodynamic result, all were immediately improved and had smooth post-operative courses. Improvement was maintained at follow-up without embolic complications despite stopping anticoagulants.
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