The aims of this study were to review the principles underlying use of the Carpentier-McCarthy-Adams IMR ETlogix® asymmetric annuloplasty ring for the treatment of chronic ischemic mitral regurgitation and to report medium-term clinical outcomes observed at our center. The in-hospital mortality rate was 2.8%. Echocardiography at hospital discharge confirmed the absence of mitral regurgitation in 88.8% of patients. Patients underwent clinical and echocardiographic follow-up (median duration, 23 months; range, 12-44 months). Late follow-up echocardiography demonstrated the recurrence of moderate mitral regurgitation in 5.7% of patients and of moderate-to-severe mitral regurgitation in 2.9%. The rate of survival free from recurrence of ≥grade-2 mitral regurgitation was 95.2% at 15 months and 88.9% at 25 months. Mitral valve repair using the asymmetric Carpentier-McCarthy-Adams IMR ETlogix® ring in patients with chronic ischemic mitral regurgitation enabled regurgitation to be effectively corrected by producing asymmetric changes in the morphology of the mitral ring. Medium-term outcomes, with regard to the degree of mitral valve competence, were excellent.