The case involved a 26-year-old woman with Marfan syndrome (MFS) and severe mitral valve regurgitation who hoped to bear a child. Anticipating future surgery to treat cardiovascular disease via a median sternotomy, we performed mitral annuloplasty via a right anterior thoracotomy. Mitral valve repair for mitral valve regurgitation via a right anterior thoracotomy is one of the most beneficial procedures for patients with MFS.