Can a leaky mitral valve be repaired or best to have it replaced?

Depends: Repair is always preferable to replacement but not all valves can be repaired. In general, leakage (regurgitation) due to mitral valve prolapse is usually amenable to repair. An echocardiogram is the best way to determine prior to surgery if the valve can be repaired.

90% should be repair: On average 90% of patients with mitral regurgitation diseased valves should be amenable to surgical repair. This can usually be done with minimally invasive surgical techniques.