Two annuloplasty techniques were compared in 109 patients, who underwent mitral valve repair for mitral regurgitation. One group of 55 patients received a Carpentier-Edwards (CE) ring, and a second group (n = 54) underwent mural annulus shortening suture (MASS) to reinforce the posterior annulus. There were four early deaths (3.7%) in the CE group, no early death in the MASS group, and one late death in each group. One patient in each group required reoperation for severe mitral regurgitation. At 12 months after MASS, postoperative Doppler echocardiography demonstrated significantly lower mean mitral valve gradients (1.7 ± 0.7 versus 2.7 ± 1.7 mmHg; p <0.01), and significantly larger mitral valve areas (3.3 ± 1.0 versus 2.6 ± 0.7 cm²; p <0.01); there was no significant difference in postoperative mitral regurgitation between the two groups. Both annuloplasty techniques showed excellent results; however, the hemodynamic performance of MASS was superior to that of the CE ring, while not increasing postoperative mitral regurgitation.