This study is about comparing two ways to fix a heart problem called mitral regurgitation (MR), where the heart's mitral valve doesn't close tightly, causing blood to flow backward. The study is comparing a special device called the MitraClip™ to traditional surgery. This study is for people with severe MR who might have trouble with surgery because of their health or age.

To join, you must be at least 18 years old, have severe MR, and be able to have mitral valve surgery or use the MitraClip™. You must not have had recent heart surgery, other serious heart issues, or be in another study. You also need to be able to follow all study rules and visits.

• The study involves random assignment to either MitraClip™ or surgical repair.
• Participants must be at moderate surgery risk or older than 75 years.
• Written consent is needed, and the study will involve follow-up visits.