Figure legends
Figure 1. Anterior mitral valve leaflet patch augmentation with true-sized annuloplasty. Reproduced with permission from reference #17.
[A] After the true-size annular measurement according to the usual principle (i.e., based on the size of the anterior leaflet and on the inter-trigonal distance), an incision is made along the anterior mitral annulus (the dashed line).
[B and C] A CardioCel (LeMaitre Vascular, Burlington, Mass., USA) patch slightly larger than the space area succeeding the “fall” of the anterior mitral leaflet is prepared and sutured on the leaflet, followed by a true-sized semirigid ring annuloplasty.
[D] Systolic anterior motion is never a concern, as the patch-augmented anterior mitral valve leaflet is always “pushed” toward the left atrium during the systolic phase.
Figure 2. Posterior mitral valve leaflet patch augmentation with true-sized annuloplasty in patients with severe ischemic mitral regurgitation due to significant posterior leaflet (i.e., P3) tethering. Reproduced with permission from reference #54.
[A] A commissure-to-commissure incision is made along the posterior mitral annulus (the dashed line).
[B] A CardioCel patch slightly larger than the space area succeeding the “fall” of the posterior mitral leaflet (whereas deferring to its shape and curvature) is prepared and sutured on the leaflet, followed by a true-sized semirigid ring annuloplasty.