"Dr. Rocha e Silva performed a mini-thoracotomy. Although we spoke about a valve replacement, once he opened me up, he saw that the cords to the mitral valve had become detached, but were otherwise intact. He reattached them and placed a Carpentier ring to provide stability. He was very kind, the kind of surgeon who has time for his patients. Every year I have a check-up (including transthoracic echo) and the repair has remained stable (e.g., no change in ejection fraction of 65.16 year over year). He operates at Incor in São Paulo, and the cost of surgery was a small fraction of that in the United States (but you would want to be able to speak Portuguese!)"