Although recent data from various registries document that mitral valve repair has increased in frequency over the past decade, approximately 1 in 4 patients continue to undergo valve replacement [1]. While the techniques for repairing the prolapsing posterior leaflet are relatively well established [2], such that most experienced surgeons can repair over 95% of posterior leaflet prolapse, reproducible and systematic repair of the prolapsing anterior leaflet remains a challenge [3]. Almost all published series have documented the increased rates of valve replacement for isolated anterior (ALP) or bileaflet prolapse (BLP) as opposed to posterior leaflet prolapse [4-6]. Furthermore, repairs of anterior and bileaflet prolapse seem to be less durable than that for posterior leaflet prolapse [7]. We sought to clarify the current outcomes of mitral valve repair for ALP and BLP in an "all comers" population in a high-volume mitral reference centre.