The need to include a mitral annuloplasty procedure during mitral valve repair was assessed in 62 patients with mitral incompetence due to degenerative disease. Four different techniques were compared: local posterior annuloplasty; use of a Carpentier ring; use of a Duran ring; and posterior annuloplasty with autologous pericardium. Our data indicate that the use of an annuloplasty procedure provides a more effective and stable result, and thus should be considered for all patients undergoing mitral valve repair.