Redo mitral valve repair with complete ring implantation over an open band

We present a case of redo mitral valve surgery after failed repair that consisted of implantation of a complete ring over an open band implanted several years prior. The patient presented with severe central mitral regurgitation. During surgical intervention, the open band was identified consolidated with the native annulus. We elected not to remove the posterior annulus given the presence of calcification. Instead, a new complete ring was secured with single sutures posteriorly over the band and anterior to the native annulus. This approach was safe, fast, and achieved a significant reduction in annulus circumference with no residual mitral regurgitation.