Mitral insufficiency ring is typically secured to the annulus, or opening of the mitral valve, to provide additional structural support. In some cases, the "double orifice" (or 'Alfieri') technique for mitral valve repair, the opening of the mitral valve is sewn closed in the middle, leaving the two ends still able to open. This ensures that the mitral valve closes when the left ventricle pumps blood, yet allows the mitral valve to open at the two ends to fill the left ventricle with blood before it pumps. In general, mitral valve surgery requires "open-heart" surgery in which the heart is arrested and
Mitral valve repair still low) risk of stroke. One cardiac surgery professor said, "I think the only benefit is for cosmesis for the patient and the benefit is for marketing and growing our practices for ourselves because it’s a good way to grow one's practice." Robotic mitral valve repair operations are also being utilized throughout the United States. In the 2000s there have been several trials of a newer strategy of mitral valve repair that does not require major cardiac surgery. Through a catheter inserted in the groin, the valve leaflets are clipped together. This technique – percutaneous mitral valve repair – is