The severe mitral regurgitation is a clear indication to intervention of mitral repair which has advantages compared to traditional surgery, preserving the contractile function of the left ventricle, reducing the incidence of adverse events related to the system of the prosthesis, by reducing the hospital mortality, morbidity and hospitalization, improving the long-term survival. The surgical risk of mitral plastic surgery presents a percentage lower than 2.5% in the centers that perform no less than 140 operations per year. However, an ejection fraction (FE) of the left ventricle lower than 55% is a negative prognostic index. In addition, the mitral plastic surgery has a long and difficult learning curves, but also the indisputable advantage of less invasiveness than traditional surgery, which allows its use even in patients deemed to be at higher operative risk. The placement of a MitraClip is the evolution of conventional surgery (Alfieri's speech): percutaneous, trans-septal puncture, placing clips on the mitral leaflets to create a dual orifice and therefore decrease or completely abolish the valve insufficiency . The EVEREST II study has shown that this procedure is less effective than surgery in reducing the degree of mitral regurgitation, but the percutaneous repair of mitral regurgitation is more secure and has shown improved clinical outcomes, comparable to cardiac surgery. At a post-hoc analysis, patients who benefit most from the MitraClip patients are elderly with low ejection fraction and functional mitral insufficiency. Considering that the prevalence of mitral insufficiency in the elderly is 30-50%, it is comprehensible how the MitraClip will have certain evolution in numerical terms.