This patient had mitral valve repair in the past and now presents with shortness of breath on exertion. Transoesophageal echocardiography pre-bypass shows a tight annuloplasty with an effective MV area of 0.8 - 1.0 cm2. This is an example of mitral stenosis which is non-rheumatic in aetiology, but is due to a tight annuloplasty ring. Post bypass loops show an improved effective valve area.
