Inprimarymitralregurgitationthereareanatomicabnormalitiesofthemitralvalvecausingbackwardflow,placingahemodynamicburdenontheleftventricle.Ifthisburdenissevereandprolonged,itleadstoleftventriculardamage,heartfailure,anddeath.Thepreferredtherapyisrestorationofmitralcompetencethroughmitralvalverepair,whichissaferthanmitralvalvereplacement.Whenrepairisperformedinatimelyfashion,lifespancanbereturnedtothatofanormalinpidual.Triggersfortimelyrepairincludetheonsetofsymptomsandevidenceofleftventriculardysfunctionasdeterminedbyejectionfractionfallingtoward60%and/orend-systolicdimensionincreasingtoward40mm.