Calcific Mitral valve

I normally do not do repairs if there is calcification in rheumatic valves.
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In this 18 year old girl there was some amount of calcification (surprising since she was pretty young) On echo the calcification seemed to be more on the body of the leaflet and I was wondering if I should still repair it. I had repaired 3 patients from the child's village in the past and so the Father was badgering me to attempt a repair as he was convinced about it. In view of the favorable morphology ( I cautioned him about the high probability of replacement) I went with a plan wrt repair. On table I found A3 calcified and some calcification of P3. I also found some atrial wall calcification. I excised the calcific area of P3 and approximated that area. I excised the A3 area which was calcified leaving a sliver of tissue at the margin which was not calcified and patched it with Glutaraldehyde-Protamine-

Heparin bonded Autologous pericardium. The whole AML was prolapsing and I did a combined chordoplasty of the A123 chords using 2 Goretex CV4 sutures. I divided the posterobasal chordae of P3 to increase its mobility.. I implanted a No 38 Goretex Steel ring (which gives a Geometrical area of 3.8cm 2). The first Panel shows the patched area. The second Panel shows the good coaptation with apical saline insufflation. patient has Grade 1 rheumatic AR.Patient also had aa large LA (6.4 cms) and with Afib and I have done a biatrial emaze. You can see the Postope echo still images showing theGood Mitral Doppler velocities and acceptable gradients and mitral vavle area. There was no MR.