my 2 cents
Pre surgery, based on angiogram and echos, unquestionable for me, recommendation from surgeon was replace the aortic valve, as the only viable longer term solution.
Mitral, he thought different, pre OHS he thought he likely could repair and the actual solution at OHS was a ring and likely some repair of the MV. My Mitral damage was thougt to be primarily caused by my defective aortic valve, so maybe my case was slighlty different than many others.
Our hospital is a teaching hospital, 6 senior surgeons, 4 op rooms and my confidence in their skills and recommendations could not be questionned.... they do a heck of a lot of OHS and I have been led to believe that more than one senior surgeon may have worked on me because of specialized skills...likely the advantage of a big centralized facility...in Montreal there are only 2 cardiac hospitals, servicing a population of many millions...centralization was done some years ago for cardiac and quite evident to me, that it was a well oiled machine.
So because you may in your area have many choices in surgeon and facilities, this decision may be an additional one i did not face, thankfully...i just lucked out in getting my procedure done at a facility and by professionals that i would highly recommend to anyone....worked well for me and am thankful and oh, can be important for support, my hospital was only 1 1/2 hours away by car and that may be another very important consideration....distance to hsopital should also be weighed in, in your considerations, for you and the rather important close ones.
Take it from Ross, who's bee there/done it, that AVR is very likely the best route, then talk it over with your preferred surgeon(s)