This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
A 59 year old man with severe myxomatous mitral regurgitation is asymptomatic, with a left ventricular ejection fraction of 45% and an end systolic diameter index of 2.9 cm/m2. The most appropriate t/t is 
Select and explain. 
A. Mitral valve repair or replacement, B. No treatment, C. ACE inhibitor therapy, D. Digoxin and diuretic therapy
A: Mitral valve repair or replacement
Answer: A: Mitral valve repair or replacement 
Explanation: None