SO in very basic terms, if the ring was put in place when your heart was out of shape, due to self modification to compensate for a leaking mitral valve, and surgery was performed to align the
leaflets, there is a big chance that as the
heart has modified itself back towards a normal shape, that the valve has been affected again, squashed or pulled out of shape. This is not as uncommon as you think and is why valves should be repaired before they reach the severe stage of leaking.