Implantation of a mechanical valve within a flexible mitral annular ring

The implantation of a mechanical valve within the orifice of a mitral Duran flexible annular ring is presented. Exact orifice matches of the former ring and the new mechanical valve prosthesis (Advancing The Standard [ATS]; ATS Medical Inc, Minneapolis, MN) can be obtained using a standard mitral type ATS valve, when the size of the former Duran ring is larger than 31 mm. If ring dehiscence is not noted at reoperation after mitral valve repair, this procedure can be simply performed in patients with late mitral valve dysfunction requiring valve replacement.