In this episode of the STS Summer Series, Gorav Ailawadi, MD, MBA, Tsuyoshi Kaneko, MD, and an expert panel debate the merits of surgical versus transcatheter treatments and review challenging mitral valve cases such as degenerative mitral regurgitation, mitral annular calcification, functional mitral valve regurgitation, and failed bioprosthetic mitral valve. Panelists include Vinay Badhwar, MD, Mayra Guerrero, MD, Robert L. Smith II, MD, Paul Sorajja, MD, Gilbert H. Tang, MD, MSc, MBA, and Dee Dee Wang, MD.