A 79-year-old female underwent open mitral commissurotomy and thrombectomy for mitral valve stenosis and thrombus in the left atrium 21 years ago. She was admitted for congestive heart failure because of recurrent mitral valve stenosis. Cardiac echocardiography showed severe mitral valve stenosis and the calcification of the left atrium wall. We performed mitral valve replacement and removal of thrombus calcification in the left atrium. Cardiopulmonary bypass was weaned successfully. In the intensive care unit, her blood pressure (BP) dropped, central venous pressure (CVP) increased, and urine volume decreased. Cardiac echocardiography revealed functional deterioration and dilatation of the right ventricle. As medical therapy was not effective, percutaneous cardiopulmonary support(PCPS)was established through the femoral artery and vein. Then her BP increased, CVP decreased, and the right ventricular function and the dilatation improved. PCPS was removed after 3 days, and the respirator on the 13th postoperative day. She moved out of the intensive care unit on the 24th postoperative day.

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