CE Mark Study for the Harpoon Medical Device

Inclusion Criteria: * Age ≥ 18 years * Patient referred for mitral valve surgery * Presence of severe MR as read on an echocardiographic study performed within 60 days prior to procedure * Estimated post-ePTFE chordae tendineae implantation coaptation surface is adequate in the judgment of the operating surgeon and the patient eligibility committee * Degenerative mitral valve disease * Patient is able to sign informed consent and able to return for follow-up and is capable of participating in all testing associated with this clinical investigation * Women of child-bearing potential have a negative pregnancy test Exclusion Criteria: * Age \< 18 years * Infective endocarditis * Anterior or bileaflet prolapse * Functional MR * History of Mediastinal Radiation * Inflammatory (rheumatic) valve disease * Requirement for concomitant cardiac surgery (e.g., coronary artery bypass grafting (CABG), aortic valve surgery, etc.) * Symptomatic coronary artery disease * Cardiogenic shock at the time of enrollment * ST segment elevation myocardial infarction requiring intervention within 30 days prior to enrollment * Evidence of cirrhosis or hepatic synthetic failure * Pregnancy at the time of enrollment (women of child bearing age should have negative pregnancy within 14 days of surgery) * Severe pulmonary hypertension (PA systolic pressure \> 70 mmHg) * Previous cardiac surgery, or surgery on the left pleural space * Left ventricular, atrial or appendage thrombus * Severely calcified mitral leaflets * Recent stroke (\< 6 months) with permanent impairment * EuroScore (for mitral valve repair) \> 8% * Patients with contraindications to Transoesophageal echocardiography * Severe left or right ventricular dysfunction * NYHA Class IV * Renal insufficiency CKD stage 3b or worse (GFR \< 45 ml/min/1.73 m2) * Patient is participating in another clinical study for which follow-up is currently ongoing. (Co-enrollment in an investigational device or interventional study) * Patient with non-cardiac co-morbidities and life expectancy \< 1 year * Patient has a condition or conditions that, in the opinion of the Investigator, preclude participation, including willingness to comply with all follow-up procedures