I will share with you some pics from a case I performed today. I have a short video that I edited from a previous case but wanted to get this out tonight.  This is a minimally invasive MVRepair in a patient that has Mitral Stenosis.  Most cases of Mitral Stenosis are treated with an MVReplacement. This is an alternative approach whereas anterior leaflet augmentation with bovine pericardium is utilized to enlarge the anterior leaflet.  It is extremely important to detach the anterior leaflet beyond the commisures and utilize a very large annuloplasty ring. If the commisures are fused (as in this case) a commisurotomy is performed as well as addressing the fused and fibrotic chordae. In this case a 40 mm 3-D profile rigid ring. I know many of you will criticize a rigid ring in a mitral stenosis case, but I have my own philosophy and will explain in a future blog.