The long-term outcome of patients undergoing mitral valve repair (MVr) is based on what happens during the more or less 60 minutes of aortic cross clamping necessary to transform a leaking valve in a well-functioning one. As a consequence, the experience of the surgeon performing the procedure is the only determinant of the success rate that deserves to be taken into account. It is clear from the literature that the number of cases/year is inversely related to the number of early and late deaths, of repair failures and of reoperations. However, there is no agreement on the minimum caseload/year that represents the threshold to identify surgeons that can perform or not MVr. This problem then cannot be regulated by specific guidelines of by Scientific Societies, but only by the ethical perception we have of our profession.