Large defects of the mitral valve commissure can be closed only by reinforcement with new tissue. Tricuspid valve leaflet transfer is advantageous in that the tissue is always readily available, and may be subject to fewer degenerative changes than mitral homografts. Our experience with five patients was reviewed. The first patient had a no reinforcement of the transferred leaflet, and suffered a rupture of the papillary muscle, necessitating mitral valve replacement. We suggest that reinforcement of the free leaflet edge with native chordae or Gore-Tex neochordae should be performed. The four remaining patients were free from valvular regurgitation at follow up. We conclude that transfer of tricuspid valve leaflet is an attractive technique that deserves a place in the surgeonŐs arsenal of reconstructive techniques for the mitral valve.