Left ventricular (LV) rupture is an infrequent but potentially lethal complication of mitral valve replacement and repair. We report the case of an 82-year-old man who underwent mitral valve replacement and the repair of an atrial septal defect. Both valve leaflets were excised and the annulus was extensively decalcified, followed by the implantation of a bioprosthetic valve. LV rupture was diagnosed after weaning from cardiopulmonary bypass (CPB). CPB was resumed and the bioprosthetic valve was removed. The patient then underwent a unique repair using a pericardial patch, Teflon felt (Meadox Medical Inc, Oakland, NJ), and BioGlue (CryoLife Inc, Kennesaw, GA). A second valve was implanted with a successful outcome.