Mitral valve lesions are easily invaded by a variety of diseases including rheumatic heart disease, congenital heart disease, infective endocarditis, and senile degenerative heart disease, and can be divided into two main types: stenosis and insufficiency of closure. The most common pathological changes caused by invasion of the mitral valve by various pathogenic factors are thickening of the valve fibrosis, plaque formation or even calcification, and junctional fusion, leading to narrowing of the valve orifice and formation of simple mitral stenosis. Or it may cause mucus-like degeneration of the valve, lengthening or rupture of the tendon cords, and relaxation of the valve, leading to mitral valve insufficiency. In about 1/3 of cases, mitral stenosis is associated with insufficiency of closure. Those with mild lesions and well compensated heart function may have no obvious symptoms. Those with more severe or prolonged lesions may have symptoms such as weakness, palpitations, and shortness of breath after exertion. If the symptoms are obvious, the heart function is affected, and the heart is enlarged, the surgery should be performed under direct vision with extracorporeal circulation in time. There are two types of surgery: 1) mitral valve repair and shaping, i.e., the use of the patient’s own tissue and some artificial substitutes to repair the mitral valve device to restore its function, including the reconstruction and reduction of the annulus, shortening or lengthening of the papillary muscle and tendon cords, implantation of artificial annulus and artificial tendon cords, and repair of the valve leaflets. 2. Mitral valve replacement, in which the mitral leaflets and tendon cords are removed and the prosthetic valve is sutured to the annulus, is generally indicated for patients whose mitral valves are severely damaged and not amenable to valve repair surgery. In the last 20 years, mitral valve repair has made great progress, and now about half of mitral valve insufficiency cases can be repaired with autologous valve repair to improve valve opening and closing, thus avoiding the need for valve replacement, which has a high rate of postoperative complications. Generally, echocardiography shows no significant calcification of the valve or subvalvular tissues, and mitral valve insufficiency with good leaflet mobility can be considered for reconstructive repair. In patients with anterior leaflet prolapse, the classical approaches have been tendon shortening, triangular resection of the prolapsed anterior leaflet, artificial tendon replacement, and tendon grafting, but the surgical technique is complex, the operative time and the extracorporeal circulation time are long, and it has been suggested that tendon grafting limits the activity of the anterior leaflet and often leads to abnormal antegrade mitral blood flow. In the early 1990s, Alfieri et al. first reported the “edge-to-edge” technique, also known as the “double orifice” technique for mitral valvuloplasty, which attracted worldwide attention and showed excellent results with the simple operation of the “double orifice” technique and no reoperation or mitral stenosis at 4 years of follow-up, but the long-term results are controversial. However, the long-term results are still controversial. The main indications for mitral valve replacement surgery are: 1, mitral stenosis with severe valvular calcification. 2, Mitral stenosis with severe contracture and subvalvular lesions that cannot be repaired by shaping methods. 3.Micuspid stenosis with incomplete closure, the latter cannot be solved by the shaping surgery. 4.Simple mitral valve insufficiency, which cannot be corrected by shaping surgery. The main prosthetic valves used in mitral valve replacement are mechanical valves and biologic valves. Mechanical valves have good durability and are superior to the currently used biologic valves, but mechanical valves are prone to complications such as thrombosis and thromboembolism, and lifelong postoperative anticoagulant drugs (such as warfarin) can prevent thromboembolism, but they also increase the risk of bleeding, so the patient’s coagulation must be checked regularly to adjust the medication. Biologic valves avoid these complications, however, they are subject to structural degenerative changes, i.e., aging of the prosthetic biologic valve, which does not have a simple linear relationship with time but progressively deteriorates after 5-6 years of implantation, so these combined factors must be taken into account when selecting a valve, and mechanical valves are currently generally recommended for patients under 65 years of age, whereas patients over 65 years of age may be considered for For patients under 65 years of age, a mechanical valve is generally recommended, while patients over 65 years of age may be considered for a biologic valve. Of course, the patient’s general health and personal opinion must also be taken into account, and with improvements in bioprosthetic valve production technology, the service life of some brands of bioprosthetic valves can be increased to about 15 years. For patients with: 1) bleeding tendencies; 2) geographic or psychosocial reasons that prevent monitoring of anticoagulation levels; 3) occupations with high trauma risk; 4) women of childbearing age who desire to become pregnant. We do not recommend the use of mechanical valves. There is a lack of sufficient comparative evidence as to which is better, mitral valve repair or replacement, for the treatment of mitral regurgitation. However, because mitral valvuloplasty preserves the integrity of the valve-tendon-papillary muscle and allows the normal geometry and function of the left ventricle to be maintained, postoperative survival and improvement in left ventricular function and quality of life in mitral valvuloplasty patients are superior to those with mitral valve replacement. Therefore, valve repair is now the procedure of choice for the treatment of mitral regurgitation.