**Abstract**

Drawbacks persist relating to irreversibility of leaflet resection, time-consuming leaflet reconstruction with sliding annuloplasty, monoleaflet function, and systolic anterior motion (SAM) risk. Graded neochordal reconstruction mitigates many of these but has the challenge of precise sizing and possibility of leaving excessive tissue, risking SAM. When this reconstruction is based on stress analysis and shear analysis methods the outcome gives the best results. Short term evaluation has been done with good outcomes.

**Keywords:** mitral valve repair, neochordal reconstruction, non resectional repair techniques, systolic anterior movement-SAM, MRI-Magnetic resonance Imaging Stress analysis, IVT –interventricular triangle, mitral regurgitation-MR, 3DECHO-3 dimensional echocardiography
