Aesop tells a fable about arguing. On a hot day, so the story goes, two travelers argued over who should rest in the shadow of the donkey they had been riding. While they were arguing, the donkey ran off, leaving the travelers with neither shade nor a ride. The moral of this tale is that in quarreling about a shadow, we lose sight of what matters.

Actually, what matters is that in real-world practice today, there is still enormous variation among institutions and surgeons in the performance and quality of reconstructive valve surgery. A significant number of patients with degenerative mitral regurgitation and repairable heart valves still receive a valve replacement. Few, if any, surgeons practicing today equal Dr David's expertise and accomplishments in valve reconstruction. His experience reported here replicates our benchmark for mitral surgery, and we must ensure that all our patients have access to care of this quality.