 Hello, I am Dr. Devananda, Head of the Department of Cardiac Surgery at Manipal Hospitals. I have been practicing cardiac surgery for the last 18 years. Now, leaking mitral valve, every leaking mitral valve need not have to have surgery. If the leak is very, very minimal, we would definitely observe them. We may not even give any medication. But yes, we do advise them to take good care of their oral cavity, like dental hygiene, gum hygiene should be very well taken care of, because any infection in the mouth cavity, when we brush, the organisms can very easily enter the bloodstream and thereby they can go and affect a mitral valve, which is mildly dysfunctional because of the turbulence. That's the only care if somebody's mitral leak is very minimal. On the contrary, when one reaches the moderate level of leakage, whether one has symptoms or no, we start putting them on few medications, which will help the heart to perform better the intensity of leakage to remain stable for longer time. They are called as ACE inhibitors. So, these are some medications, tablets, which one need to take. When this leakage progresses over years to very severe levels, we keep doing the echoes periodically. We monitor the size of the left ventricle. Often the interventional therapy like surgeries advised based not just on the symptoms, but also on the size of the ventricle. If the left ventricle or the pumping chamber goes beyond certain size, yes, this is the time for an operation. And that is how we decide when to intervene with mitral valve leakages.