The edge-to-edge (E-to-E) technique was introduced in the early 1990s and has provided a useful contribution to the surgical armamentarium of mitral valve repair. The free edges of the mitral leaflets have to be approximated in correspondence of the site of the regurgitant jet in such a way that mitral regurgitation is corrected without producing stenosis. A prosthetic ring is usually implanted to stabilize the repair. Middle- and long-term surgical results are now available. Appropriate indications and awareness of the important technical aspects of the procedure are prerequisites for a good outcome. In this review the present role of the E-to-E repair, the relevant technical aspects of the procedure, and some controversial issues will be outlined and discussed.
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