We did not obtain institutional ethical/Institutional Review Board (IRB) approval for our submission due to the nature of our case study being a unique demonstration of medical knowledge without generalizability. J.D. designed the study, reviewed the medical record, wrote the main article, and performed a literature review. F.P. and N.C. revised the article and performed a literature review. N.C re-formatted the article and J.D. submitted the final version of the article. J.T., S.S., T.P., and K.P. critically reviewed the article and were instrumental in the evaluation and management of the patient. J.D. and F.P. performed the mitral valve replacement.