Additional Study Information: This is a randomized controlled trial (RCT) that will compare the clinical outcome of MitraClip device versus surgical repair in patients with severe primary MR who are at moderate surgical risk and whose mitral valve has been determined to be suitable for correction by MV repair surgery by the cardiac surgeon on the local site heart team. In this trial, each subject will be followed until their 10-year visit. Clinical Investigation visits will occur at Screening (for determination of eligibility), Baseline (after confirmation of eligibility), Index Procedure, Discharge, 30 days, 6 months, 1 year, 18 months, and annually thereafter from 2 to 10 years. A phone-only visit will be conducted for 6 months, 18 months, and years 6, 7, and 9 and an in-office visit will be conducted for all other time points (30 days, annually at 1-5 years, and at 8 and 10 years).