We present a rare case of mitral regurgitation with anterior mitral leaflet perforation associated with gelatin-resorcinol-formaldehyde (GRF) glue. We performed mitral valve replacement for anterior mitral leaflet perforation occurred 7 years after aortic valve replacement and abscess cavity repair using GRF glue. Long-term follow-up is needed for patients who have undergone surgeries using GRF glue or BioGlue (CryoLife, Inc, Kennesaw, GA) because of the possibility of late complications. In particular, when an eccentric mitral regurgitation is observed after aortic root surgery using GRF glue or BioGlue, anterior mitral leaflet perforation should be considered.
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