Every year, numerous patients with mitral valve insufficiency are hospitalized for surgical treatment, and these patients have often required valve replacement in the past. There are many different types of prosthetic valves used for replacement, but they are usually divided into two main categories: mechanical valves and biologic valves. Each has its own characteristics: mechanical valves are durable but require lifelong anticoagulation; biologic valves do not require lifelong anticoagulation but have a limited lifespan. In addition to the surgical approaches described above, mitral valve insufficiency can now be treated by mitral valvuloplasty, in which the patient’s own valve is completely preserved and repaired to restore its function. This began in the 1970s in developed Western countries and, after nearly 30 years of development, has resulted in a complete set of theoretical and practical methods and is now considered the surgical method of choice for the treatment of mitral valve insufficiency. So, what are the advantages of mitral valvuloplasty compared with other surgical methods? 1.Protection of left ventricular function Because mitral valvuloplasty preserves the patient’s own valve and subvalvular structures, the integrity of the left ventricular structure is not damaged, so the left ventricular function can be protected to the greatest extent. 2, avoid complications associated with prosthetic valves No structural failures that occur after prosthetic valve implantation, such as valve seizure, valve failure, or perivalvular leakage. It also does not increase the incidence of endocarditis due to foreign body implantation. 3.No need for anticoagulation After mitral valvuloplasty, anticoagulation is usually required for only 3 months. This avoids postoperative bleeding and embolism caused by improper anticoagulation, and is more beneficial to patients with contraindications to anticoagulation and women of childbearing age. 4.Low surgical risk and fast recovery Because mitral valvuloplasty can maximize the left ventricular function without affecting it, the postoperative recovery process is smoother than valve replacement and patients recover quickly. 5.High long-term survival and quality of life Mitral valvuloplasty avoids a series of unfavorable factors associated with prosthetic valves and does not require lifelong anticoagulation, so it has a better long-term survival rate and also enables patients to have a better quality of life. In particular, young women with childbearing requirements can have normal postoperative pregnancies and deliveries. Despite the obvious advantages of mitral valvuloplasty over other surgical approaches, not all patients with mitral valve insufficiency are suitable for this procedure. It is generally accepted that mitral valvuloplasty should be avoided in patients with extensive fibrosis and calcification of the valve, severe fusion of the subvalvular structures, and significant restriction of mitral leaflet motion. In addition, because of the variety of pathologic changes in mitral valve structures and the fact that the causes of insufficiency are not always the same, the success and long-term outcome of valvuloplasty surgery depends largely on the surgeon’s clinical experience and proficiency in the use of various valvuloplasty techniques, which limits its popularity.