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Mitral Valve Repair (Alfieri’s Procedure)

3D Atlas - The Mitral Valve

The Alfieri procedure or “bow-tie” repair is a simple repair method introduced by Alfieri and coll.1 in which the leading edges of the mitral leaflets are approximated by use of a suture. The location of the suture can be customized on the basis of the location of the regurgitant jet with both central and paracommissural leaflet approximation.

Mitral valve repair - ventricular sideTransthoracic 3DE volume rendering of a mitral valve repaired using the Alfieri procedure viewed from the ventricular side.

Mitral valve repair - atrial sideThe same valve viewed from the atrial side.


Mitral valve repair - porcine modelPorcine model of the Alfieri’s procedure viewed
from the atrial side (Courtesy of Fausto Rigo).



  1. Maisano F, Torracca L, Oppizzi M, et al. The edge-to-edge technique: a simplified method to correct mitral insufficiency. Eur J Cardiothorac Surg. 1998; 13: 240–245