Mitral Valve Re-Repair in an Adult Patient Having Undergone Mitral Ring Annuloplasty at Five Years of Age.

In adult patients who have undergone mitral annuloplasty with a rigid ring at a young age, the mitral valve may ultimately deform and demonstrate insufficient growth because the valve annulus is fixed to the ring. Mitral valve re-repair, following this scenario, was performed for mitral stenoinsufficiency in a 26-year-old female patient who had undergone mitral annuloplasty with a rigid ring at the age of five years. The valve re-repair procedure consisted of decalcification and stripping of the anterior leaflet and annulus, posterior leaflet augmentation using an elliptical autologous pericardial patch, and a posterior strip annuloplasty sparing the anterior annulus and commissures. Using this procedure, the mitral valve recovered sufficient coaptation area for valve competence, and anterior annular motion was resumed with resultant dynamic changes of the septolateral annular dimension.