We report a 71-year-old man with severe mitral valve regurgitation in end stage heart failure intractable to medical treatment. He underwent mitral valve repair, coronary artery bypass grafting and tricuspid annuloplasty, and his postoperative course was uneventful with significant improvement of his symptoms. Mitral valve repair should be considered as a treatment modality in patients with cardiac failure and significant mitral valve regurgitation.