Prosthesis replacement in a calcified mitral annulus with reconstruction of the intervalvular fibrous body: the value of an alternative repair.

A patient with healed prosthetic endocarditis, severe calcification of the mitral annulus, and multiple mitral periprosthetic leaks underwent double-valve replacement, with reconstruction of the intervalvular fibrous body. Placing sutures through healthy autologous tissues from outside the heart enabled secure replacement of the mitral prosthesis. This technique avoids extensive circumferential reconstruction of the mitral annulus.