Mitral valve repair is generally favored over replacement, even during complex procedures like concomitant coronary artery bypass grafting (CABG) or multi-valve surgeries. Here’s why:

• Preserves Heart Function: Repair maintains the native valve and subvalvular apparatus, supporting better left ventricular function.
• Lower Risk of Complications: Compared to replacement, repair carries lower risks of endocarditis, stroke, and thromboembolism—often without the need for lifelong anticoagulation.
• Improved Long-Term Outcomes: Studies consistently show better survival and quality of life post-repair, even in high-risk or combined procedures.
• Durability with Modern Techniques: Surgical advances have made repair reliable and effective across a broad range of valve pathologies. Whenever feasible, repair is the gold standard—even in complex cardiac cases.