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Figure 3 Three-dimensional (3D) images of mitral annulus and leaflets in ischemic mitral regurgitation. (A) Anatomical 3D image (views from two directions). Mitral annulus flattened with apparent tenting of the mitral leaflets, which were tethered into the left ventricle (LV), showing mountain-shape leaflet bulging. (B) Actual 3D tenting image. Mitral leaflets are apparently tethered and annular height is shorter compared with normal. Mitral annulus is dilated. Black dots indicate coaptation line. (C) Corrected 3D tenting image. Mitral leaflets are tethered almost symmetrically from the level of mitral annulus (left). Maximum tenting length is longer than control (right). Black dots indicate coaptation line. The green mark indicates the maximum tenting site of the leaflet. In this particular patient, the maximum tenting site is located at middle of the anterior leaflet. Abbreviations as in Figure 3.