A method and system for intraoperative guidance in an off-pump mitral valve repair procedure is disclosed. A plurality of patient-specific models of the mitral valve are generated, each from pre-operative image data obtained using a separate imaging modality. The pre-operative image data from the separate imaging modalities are fused into a common coordinate system by registering the plurality of patient-specific models. A model of the mitral valve is estimated in real-time in intraoperative image data using a fused physiological prior resulting from the registering of the plurality of patient-specific models.