With innovative repair techniques, mitral valvuloplasty can be safely and successfully performed even in the presence of complex mitral apparatus pathology , , , , , –. Our experience demonstrates good and stable results after valvuloplasty in cases that would otherwise have been subjected to valve replacement. The ultimate goal apparently is restoration of a “neo-valve” with normal valve function while avoiding the use of foreign materials. Modern techniques of surgery described here, in conjunction with precise echocardiographic evaluation, will aid in meeting these requirements. The methods of surgery are well reproducible and can be performed within a short period of time. They permit either long-term or definitely successful valve repair.