Assessment and management of a 1.77-cm 2 mitral leaflet perforation as a subclinical cause of mitral regurgitation.

Anterior mitral valve perforations are commonly due to underlying infective endocarditis, which can lead to significant mitral valve insufficiency. In these cases, clinicians should have a high index of suspicion for infective endocarditis. After appropriate imaging, immediate surgical intervention is unequivocally the choice of management here for optimal patient outcomes.