Abstract
Congratulations to the authors for this valuable study [1]. We believe there are some points that have to be clarified. Although leaflet retraction is the main pathology in rheumatic mitral stenosis that has to be corrected, leaflet extension or augmentation was used in 4.1% in this study. Again, in the study group, patients developed both mitral stenosis and insufficiency due to leaflet retraction. As repair technique, commissurotomy was used in 57%, leaflet mobilization in 51% and new chorda formation in 22%. But, the answer to ‘where would coaptation of leaflet edges during systole be?’ seems to be left in the hands of the mitral ring. How could we solve this problem in repair if the main question is ‘where will the leaflet edges during systole be and how can we ascertain their coaptation?’
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