▁heart ▁sur geon , ▁Dr . ▁A lain ▁F . ▁Car pent ier . ▁A ▁repair ▁still ▁involves ▁major ▁card iac ▁surg ery ▁but ▁for ▁many ▁patients ▁presents ▁the ▁significant ▁advantage ▁of ▁avoid ing ▁blood ▁th inners ▁and ▁may ▁provide ▁a ▁more ▁dur able ▁result . ▁Not ▁all ▁dam aged ▁val ves ▁are ▁suitable ▁for ▁repair ; ▁in ▁some , ▁the ▁state ▁of ▁val ve ▁disease ▁is ▁too ▁advanced ▁and ▁replacement ▁is ▁necessary . ▁O ften , ▁a ▁sur geon ▁must ▁decide ▁during ▁the ▁operation ▁itself ▁whether ▁a ▁repair ▁or ▁a ▁replacement ▁is ▁the ▁best ▁course ▁of ▁action . ▁ ▁For ▁patients ▁with ▁the ▁most ▁common ▁type ▁of ▁mit ral ▁val ve ▁disease , ▁term ed ▁" de gener ative " ▁or ▁" my x om at ous " ▁mit ral ▁val ve ▁disease , ▁repair ▁rates ▁are ▁very ▁high ▁and ▁long ▁term ▁dur ability ▁is ▁excellent . ▁ ▁There ▁has ▁been ▁great ▁debate ▁about ▁timing ▁of ▁surg ery ▁in ▁patients ▁with ▁asympt om atic ▁mit ral ▁val ve ▁reg urg itation . ▁ ▁The ▁traditional ▁surg ical ▁approach ▁to ▁a ▁mit ral ▁val ve ▁repair ▁is ▁a ▁full ▁or ▁partial ▁stern ot omy , ▁in ▁which ▁the ▁sur geon ▁cut s ▁through ▁the ▁breast bone ▁at ▁the ▁center ▁of ▁the ▁ch est ▁to ▁access ▁the ▁heart . ▁ ▁There ▁are ▁minim ally ▁invas ive ▁( port ▁access ) ▁options ▁available ▁pione ered ▁by ▁Hugo ▁Van erman ▁in ▁Belg ium . ▁ ▁The ▁minim ally ▁invas ive ▁approach ▁does ▁not ▁involve ▁cutting ▁the