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This is a case of an 82-year-old woman who initially underwent a mitral valve repair followed by a biological mitral valve replacement. However, she later presented with mitral regurgitation, and possible vegetations on the valve led cardiologists to avoid placing a transcatheter valve. The patient also had a pacing wire in place, and this operation was performed through a right atriotomy and then through the atrial septum, cutting through the fossa ovalis.
Previous use of Cor-Knots required their removal to prevent embolization. Once removed, the valve was carefully detached from the endocardium while minimizing damage to the annulus. A chordal-sparing technique was utilized, preserving the chords during the complicated dissection of the previous biological valve. Finally, a new biological valve was inserted, and the operation was concluded.
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