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The edge-to-edge repair (EtER) technique was introduced in 1991 to treat both mitral regurgitation (1) and tricuspid regurgitation (2) caused by complex valvular lesions. The method involves anchoring the free edge of the diseased leaflet to the corresponding edge of the opposing leaflet, just at the place of the regurgitant jet. When the middle sections of the leaflets are sutured, a ‘double-orifice’ mitral valve is artificially created (Fig. 1b). This procedure is recommended for the treatment of bileaflet prolapse (Barlow’s disease), anterior leaflet prolapse, commissural prolapse, and functional mitral regurgitation. The main consequence of the EtER technique is that the mitral valve geometric orifice area (MGOA) is reduced to a point where a functional mitral stenosis might be created. Consequently, the ability to predict the MGOA following EtER is important in order to limit the reduction in left ventricular preload and to avoid any mismatch between the MGOA and the patient’s blood demand. The study aim was to determine the MGOA mathematically, by using a simple non-invasive formula following EtER, and to examine the influence of the suture position on the resultant MGOA. The mathematical formula used was validated by using ex-vivo bovine mitral valves.