The best treatment for a flail leaflet depends on the severity of the valvular dysfunction5. In most cases of flail leaflet, the valvular dysfunction is severe, and management involves valvular repair with cord repair/suspension or valve replacement5. The Mayo Clinic experience suggests that most patients with isolated leaflet prolapse can be managed with leaflet plication or triangular resection, and chordal replacement is reserved for patients with more complex pathology2. In some cases, early surgery may be recommended, while in others, conservative management with possible deferred surgery may be an option1. Surgical treatment of mitral regurgitation due to flail leaflet improves symptoms and is considered indicated primarily for patients with NYHA6. In general, patients with a flail leaflet will need their valves fixed because the leak is very severe, and the problem will likely only get worse4. The timing of surgery depends on the severity of the symptoms and the degree of valvular dysfunction4.