Congratulations, Dr Maisano, for a fine presentation. You have represented Dr Alfieri&'s group well at previous meetings, and today is no exception. After having just heard the world&'s largest experience from the citadel of the “Alfieri stitch,” as we call it—although out of modesty Professor Alfieri terms it the “edge-to-edge technique”—I thought it would be helpful for the audience to take you through the last 5 years of the literature with respect to what we have learned about this technique. The original 1995 Fucci paper showed that the edge-to-edge repair was employed in 35 cases out of 299, or only 12% of their repairs. In this early learning phase it probably was used as a “bail-out” maneuver often, that is, where after a conventional repair persistent problems such as residual anterior leaflet prolapse were identified and the leaflets were therefore sutured together. Then, at the 1997 EACTS meeting in Copenhagen your group had applied the edge-to-edge technique in 28% of 432 patients. In your overall experience presented today, this fraction is now up to 35% of mitral repairs; perhaps most importantly, it was the only procedure you performed on the leaflets per se in 75% of these Alfieri patients. Now, why is that? You are obviously gaining more confidence in this procedure, but some of this increased usage is due to the fact that you are doing an Alfieri stitch in a growing subpopulation of young patients with Barlow&'s syndrome. You presented at the EACTS meeting in Glasgow last September that all you do is a 2 to 3-cm long running stitch between the billowing central portions of the leaflets in these Barlow&'s cases without any leaflet resection. Should we really abandon leaflet resection and Carpentier&'s original techniques and just do this? Or, conversely, is your 75% usage of only the edge-to-edge technique without other leaflet procedures due to this large minority, possibly a majority, of Barlow patients?