Schema of rough-zone trimming (RZT). (a) Medial scallop (A2) of anterior mitral valve leaflet (AML) is elongated and prolapsed after previous ESS. (b) Prolapsed A2 site resected in shape of obtuse triangle limited to rough-zone. (c) Resected edges repaired with 6–0 monofilament sutures. Repaired site of valve leaflet was taken down into left ventricular side and deeper coaptation improved mitral valve regurgitation.