Research/studies to support repair over replacement

  Hello,
  I'm presenting my medical case to my insurance company in an effort to "prove" to them that mitral valve repair(rather than replacement)is an acceptable and more desirable procedure in the case of 4+ mitral regurgitation due to myxomatous degeneration and prolapse. I've found a surgeon who will make every attempt to repair my mitral valve before replacing it and he will argue my case, but he is not in the HMO network. I, therefore, was told that I should submit any documentation I have to validate all that I have learned on this Heart Forum. Do you have access to a bibliograpy of studies and articles on this subject? It was also suggested I find out the costs (long term and short term) of repair vs. replacement. Do you know how I can find this information?
  Thank you.
  Barry

[Cleveland Clinic, MD]

Dear Barry,
This is yet another case of corporate profits coming before good patient care.  It is well known in the medical community that using the native valve is better than an artificial valve.  Valve repair is the procedure of choice here at the Cleveland Clinic for mitral valve regurgitation if at all possible.  Dr. Cosgrove, the head of cardiac surgery,  is one of the pioneers of valve repair and the majority of patients that come here for mitral regurgitation receive valve repair.  You could point out this fact to your HMO.  As far as randomized studies with repair vs. replacement I don