Figure 2
(A) Degeneration of posterior medial scallop and annular calcification of posterior leaflet were noticed. Anterior leaflet was resected. (B) Posterior leaflet was plicated twice, and the sutures were passed through an equine pericardium. (C) The prosthetic valve was fixed with the above-mentioned sutures in the posterior area, and in the conventional everting manner in the anterior area. The equine pericardium was sutured to the left atrial wall to cover the annular calcification. AL: anterior leaflet; PL: posterior leaflet; MAC: mitral annular calcification; EP: equine pericardium; P: pledgets; PV: prosthetic valve.