Patients undergoing mitral valve repair for severe degenerative regurgitation and normal preoperative left ventricular (LV) function (group 1, LV ejection fraction, LVEF >50%) were compared with patients with depressed LV function (group 2, LVEF <50%). One year after mitral valve repair, LVEF was preserved and LV end-systolic and diastolic diameters were significantly reduced in group 1 patients. LVEF was significantly improved and LV diameters returned to normal values in group 2 patients. These findings provide evidence that poor preoperative LV function and cavity dilatation should not be considered contraindications to mitral valve repair.