Selective, segmental decalcification: a safe alternative to extensive debridement of a severely calcified annulus during repair of mitral regurgitation

Resection of the calcium bar and creation of a more compressible annulus with pericardium are necessary in case of extensive calcification of the mitral valve annulus in patients with advanced myxomatous degenerative disease. Such annular bar calcification is technically challenging and represents a risk factor for death following mitral valve operations, because of atrio-ventricular rupture or encroachment of the coronary arteries. We describe a safe limited segmental annular debridement away from the coronary arteries that allows enough flexibility of the remaining calcified annulus to perform reduction annuloplasty in a young female patient with severe mitral regurgitation and a highly dilated and severely calcified mitral annulus.