My mother is a healthy 73 yer old who was recently diagonosed with a flailing posterior mitral valve leaflet with 3+ MR. Strange thing is she is totally asymptomatic. Her cath showed clean cornoaries and good EF without pul. HTN or arrythmias. Her cardiologist recommends surgery for MV repair with standard sternotomy. Questions: 1)do you think surgery in nessary or can she be treated with medication as she has very good excercise tolerance. 2)has minimal invasive surgery evolved/matured enough as a true alternative to standard sternotomy for a MV repair. 3)I am confused about all the various minimal invasive surgeries that are available from mini-low sternotomy, mini thoracotomy, Port access, AESOP?, robotic assisted, endoscopic. Can you please explain generally the various techniques and which one has been done most 4) Can you recommend instutions here in North Carlina that does good number of minlmal invasive cardiac mitral valve repair. Thank you very much.