Fig. 2

Intraoperative images. a Calcified amorphous tumor of the middle posterior leaflet with mitral annular calcification (white arrow). b Caseous calcification of mitral posterior leaflet and annulus (white broken arrow). c Debrided mitral annulus after removal and debridement of calcified amorphous tumor and mitral annular caseous calcification. d A patch repair with bovine pericardium of posterior mitral valve annulus. e A mixed suture technique consisted of non-everting mattress sutures in the middle posterior annulus and everting mattress sutures in the anterior annulus, and lateral and medial posterior annulus