Mitral valve insufficiency in rheumatic heart disease is often due to retracted posterior chordae and posterior leaflet thickening. Several surgical repair techniques have been described, but sometimes an acceptable coaptation of the mitral leaflets can not be achieved. Rather than accept a mitral regurgitation or resort to a mitral valve replacement, particularly in children, we have added a suspension of the posterior leaflet directly to the annuloplasty ring. This additional surgical repair technique was performed in 10 patients with a perfect coaptation of the mitral leaflets with immediate results and excellent mid-term results, without evidence of either mitral regurgitation, mitral valve stenosis, or leaflet abrasion due to the suspension sutures.