This video demonstrates pre-repair clips and is divided into three sections. The initial images present a mid-esophageal four-chamber view showing a dilated left atrium and absence of mitral leaflet coaptation. The next section demonstrates severe mitral insufficiency by colour-flow Doppler. The last section shows a hyperdynamic left ventricle with absence of pericardial haematoma. View Video 1 at http://movie-usa.glencoesoftware.com/video/10.1530/ERP-15-0026/video-1.