Mitral valve repair available in Europe but still in clinical trial in the United States. It is a highly specialized technique only available at select hospitals. Early trial results suggest that it may be a beneficial approach for patients who are at high risk from conventional surgery. As early as January 2000 a team of doctors at the "Instituto de Cardiología y Cirugía Cardiovascular" in La Habana, Cuba have performed beating heart mitral valve repair or replacement. The beating heart mitral valve replacement technique is as safe as the arrested heart technique, and is the recommended alternative to arrested heart technique. The analogy
Mitral insufficiency subsequent displacement of the papillary muscles and the dilatation of the mitral valve annulus. Rheumatic fever (RF) and Marfan's syndrome are other typical causes. Mitral valve stenosis (MVS) can sometimes be a cause of mitral regurgitation (MR) in the sense that a stenotic valve (calcified and with restricted range of movement) allows backflow (regurgitation) if it is too stiff and misshapen to close completely. Most MVS is caused by RF, so one can say that MVS is sometimes the proximal cause of MI/MR (that is, stenotic MI/MR) and that RF is often the distal cause of MVS, MI/MR, or both.