The problem of elevated postrepair MV gradients was initially described in patients after restrictive mitral annuloplasty for ischaemic MR [4] but may also be of clinical importance in patients with degenerative MR [3, 5]. To justify the growing enthusiasm for early surgery of yet asymptomatic patients with degenerative MR, optimal patient- and valve-related results are needed. Data on the risk factors and clinical impact of elevated MV gradients following valve repair for degenerative disease remain scarce.