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 valve away from the free margin. This disposition has important effects on systolic stress distribution physiology The mitral annulus is a fibrous ring that is attached to the mitral valve leaflets. Unlike prosthetic valves, it is not continuous. The mitral annulus is saddle shaped and changes in shape throughout the cardiac cycle. The annulus contracts and reduces its surface area during systole to help provide complete closure of the leaflets. Expansion of the annulus can result in leaftlets that do not join soundly together, leading to functional mitral regurgitation. The normal diameter of the mitral annulus is , and the circumference