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Figure 4 Diagram of a midsystolic tented mitral leaflet geometry (left top) with a typical leaflet contour imaged by two-dimensional echo from the apical view (below). Left ventricular side in z direction. The occlusional leaflet area, OLA, was calculated as the sum of fractions of a cone produced from four apical scanning planes rotated around an axis through the midpoint of the annulus (right top; one fraction of a cone is marked). Notice leaflet edge separation due to leaflet asynergy creating a regurgitant orifice. Variables to describe leaflet configuration are illustrated (r and h). The intersection of the anterior leaflet extension on the posterior leaflet gives the horizontal length r4 and perpendicular distance h4 of the posterior leaflet involved in mitral orifice occlusion.  AL and PL = systolic leaflet coaptation angle of the anterior and posterior leaflet; DAL, DPL = perpendicular distance from anterior and posterior leaflet tip to the annular plane; LAL, LPL = horizontally projected lengths of the anterior and posterior leaflet.
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