Successful mitral valve repair (MVR) has been reported via median sternotomy in patients with previous MVR. This video demonstrates a second MVR in a patient with complex bileaflet prolapse (Barlow's) using thoracoscopic assistance, right minithoracotomy and two serial cosgrove rings for the dilated annulus. A 68 year old male developed severe mitral regurgitation and atrial fibrillation seven years after undergoing quadrangular resection, sliding plasty and annular plication with pericardial strip. TEE revealed a massively dilated annulus, bileaflet prolapse with multiple regurgitant jets and preserved ventricular function. The patient underwent video-assisted cryoablation and MVR consisting of bilateral commissuroplasty, Goretex neo-chords to A2 and P2 segments and Cosgrove ring annuloplasty. Because of the size of the annulus, a #38 ring was placed around two-thirds and another #26 ring was placed around one-third of the posterior annulus after some trimming. Post-operative TEE revealed no mitral regurgitation. He was discharged home on the fifth postoperative day. This is the first reported use in literature, of two annuloplasty bands for MVR in Barlow's valve. The durability of the repair remains to be seen. However, this technique can be useful to a surgeon dealing with a massively dilated mitral annulus.