My husband is 32 years old and in good health other than mitral valve regurgitation which has gotten to the point that something needs to be done. When he was 18, his aortic valve was replaced with an artificial valve and that valve seems to be working fine. Now he has a flail leaflet in the mitral valve and we have gotten various opinions regarding whether the valve should be repaired or replaced. We were told by one doctor that the advantage of repair is to avoid coumadin, but he is already on it for the aortic valve. Another doctor told us that an artificial valve can cause swelling of the heart chamber and that there is a great advantage to having the existing valve repaired rather than replaced. This doctor recommended Cleveland Clinic for the repair and before we go to all the trouble to make the trip out there, we were wondering if you could tell us a little more about the pros/cons of both options. Also, we were wondering what the chances are that another leaflet would break after the repair and he would have to go through the surgery again.