Brescia AA, Watt TMF, Rosenbloom LM, et al. - Given the superiority of mitral valve repair vs replacement for degenerative disease, but poor knowledge regarding long-term outcomes of anterior vs posterior leaflet repair, researchers propensity matched anterior and posterior repairs to compare long-term results. They identified patients receiving first-time degenerative mitral repair between 1992 and 2018. Overall survival was the primary outcome. Longer bypass and crossclamp times were reported for anterior repairs. For anterior repair and for posterior repair, the mean residual mitral regurgitation grade was 0.44 and 0.30, respectively. Following anterior repair and after posterior repair, the cumulative incidence of reoperation at 15 years was estimated to be 7.5% and 4.9%, respectively. Findings revealed no long-term survival or reoperation disparity between posterior and anterior repair. Considering these observations, surgeons at centers of excellence are advised to goal for repair of both anterior as well as posterior leaflet pathology with the same decision-making threshold over valve replacement for degenerative mitral disease.