**3. Conclusion**

The standardization of the preoperative, intraoperative and postoperative echocardiographic examination is crucial for the skilled dialogue with the surgical team and for the results. As the surgery of degenerative mitral insufficiency is somehow standardised, echocardiography should also be as standardised as possible. The use of a specific pattern of lesion confers better and tailored surgical planning, adapted to each given case. Use of different types of patterns such as mitral valve flail, undulating valve or marginal prolapse facilitates the dialog with the surgeon.

Alongside specific patterns of lesions, a crucial point in surgical repair is the evaluation of the mitral geometry. Apart from the three dimensional echo, the main tool in assessing the mitral valve geometry by 2 D echocardiography, is the coaptation triangle.

The echocardiographer must consider the mitral valve as an eight-element anatomical structure, and separately assess each segment. The preoperative exam has to be done based on a structural echocardiographic algorithm and finally expressed as a prolapsing score.

By using this strategy, the mitral valve repair is feasible, with excellent results.

In dedicated centres, the mitral valve repair for degenerative disease is possible with more than 95% rate of success. The use of the triangle of coaptation, coaptation length and coaptation height as geometric echocardiographic concepts aiming to restore the mitral valve shape and coaptation, is a crucial point to improve the surgical planning and results.
