Mitral valve repair surgery for mitral regurgitation (MR) has a multi-decade history beginning in the 1950s with Davila and colleagues' circumferential suture mitral annu-loplasty and Lillehei and colleagues suture commissural fusion. In 1960, McGoon pioneered direct leaflet repair via interrupted suture plication of the prolapsed leaflet segment. By the next decade, Carpentier and colleagues had developed a host of novel reconstructive techniques ranging from leaflet resection to native chordal repositioning, all augmented by remodeling prosthetic ring annuloplasty. Decades later, the classic quadrangular resection remains for most surgeons, the mitral valve repair technique of choice. The capability for high-probability mitral repair success now justifies early operation in asymptomatic patients.
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