How did a simple stitch transform mitral valve repair? In this episode, we spotlight the pioneers of cardiothoracic surgery, Ottavio Alfieri and Francesco Maisano - the minds behind the edge-to-edge repair. They revisit the early 1990s, when mitral repair was complex and inconsistent, and share how the now-famous Alfieri stitch—inspired by a congenital double-orifice valve—offered a simple, reliable solution. From early skepticism to global adoption and the rise of transcatheter therapies like MitraClip, this conversation traces how one elegant idea reshaped mitral valve treatment and continues to influence the future of structural heart therapy.