Fig. 1

Representative appearances of the mitral leaflets before and after mitral valve plasty. White thick intima was covered with both mitral leaflets and there was localized calcification in the middle of the both leaflets and around the postero-median commissure (left). The thick leaflets became thin and the mobility of the leaflets increased after leaflet slicing (right) a. Both mitral leaflets included mild atherosclerotic lesion without commissural fusion b. The antero-laretal commissure was affected by advanced atherosclerotic calcification, which extended to the center of both leaflet c. In the most advanced case, the mitral leaflet around the antero-lateral commissure seemed to be destroyed by the broad severe atherosclerosis (left). However, thin mobile mitral leaflets appeared after careful decalcification and leaflet slicing (right) d