Regional Changes in Coaptation Geometry After Reduction Annuloplasty for Functional Mitral Regurgitation David G. Greenhouse, MD, Sophia L. Dellis, BA,

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Regional Changes in Coaptation Geometry After Reduction Annuloplasty for Functional Mitral Regurgitation David G. Greenhouse, MD, Sophia L. Dellis, BA, Charles F. Schwartz, MD, Didier F. Loulmet, MD, David W. Yaffee, MD, Aubrey C. Galloway, MD, Eugene A. Grossi, MD The Annals of Thoracic Surgery Volume 93, Issue 6, Pages 1876-1880 (June 2012) DOI: 10.1016/j.athoracsur.2012.02.066 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Schematic representation of the measurements made in the 3 regions of the mitral valve. Representative echocardiographic images of measurements made during (B) diastole and (C) systole. The following measurements were made in (B) diastole: septolateral annular dimension (SLAD; from anterior annulus to posterior annulus, arrows 1 to 3), anterior leaflet length (ALL), and posterior leaflet length (PLL), and in (C) systole: anterior coaptation distance (ACD; from anterior annulus to point in annular-plane overlying coaptation-point), coaptation depth (CD; from annular plane to coaptation-point), anterior coaptation length (ACL), and posterior coaptation length (PCL) (length of leaflet engaged in coaptation calculated by subtraction from diastolic leaflet length). (PCD = posterior coaptation distance.) The Annals of Thoracic Surgery 2012 93, 1876-1880DOI: (10.1016/j.athoracsur.2012.02.066) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Semirigid band annuloplasty was associated with increased coaptation lengths in all regions (a) (p < 0.01). Increased anterior coaptation length was nonuniform between regions, with the greatest increase seen in region 2 (b) (p = 0.01). (A) Anterior; (B) posterior. (□ = preoperative; = postoperative.) The Annals of Thoracic Surgery 2012 93, 1876-1880DOI: (10.1016/j.athoracsur.2012.02.066) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions