Response to Letter Regarding Article, “Initial Results of Posterior Leaflet Extension for Severe Type IIIb Ischemic Mitral Regurgitation”

As Dr Messas et al point out in their letter about our article,1 surgeons should attempt to restore function when addressing mitral regurgitation. The mitral valve is complex, and more than 1 cause of mitral regurgitation can be present at any one time. Carpentier’s classification was revolutionary because it was the first functional classification that truly allowed surgeons to identify and use repair techniques that would render the valve competent independently from the pathogenesis of the regurgitation. Carpentier …