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Despite ongoing advances in medical and surgical therapy of mitral valve infective endocarditis (IE) disease, patients with these acute problems still remain have high morbidity and mortality especially concomitant with the embolic complication. Mitral valve repair is now considered the preferred treatment of mitral regurgitation caused by leaflet prolapsed and also in perforated and destroyed leaflet of IE disease. In the setting of IE, some concerns have been raised about the efficacy, durability and the timing of the complex repair particularly in the acute phase. Surgical intervention for IE is technically challenging because of the extensive tissue destruction that require reconstruction after radical debridement of infected and necrotic tissue. In this study case, a 63-year-old woman, who had a recent recovery from right hemiplegia caused by septic emboli from active mitral valve infective endocarditis was successfully underwent mitral valve repair 9 days after onset of neurologic event. After surgery, she had normal mitral valve function and no further aggravation of the brain complication.