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Ancona et al. Mini-invasive Surg 2020;4:79 I http://dx.doi.org/10.20517/2574-1225.2020.80 Page 11 of 23

Figure 9. Assessment of leaflets insertion. Verification of satisfactory grasp of the leaflets requires multiple views: 4-chamber view (A),
commissural view (B), long axis view (C), transgastric short axis view (D), 3D en face view (E); measurement of leaflets length before
and after grasping (F); multiplanar reconstruction allows simultaneous visualization of different views (G)

Figure 10. Assessment of Leaflets Insertion: Indirect Signs. 2D color Doppler (A) and 3D LV perspective (B) showing a residual intraclip
jet; appearance of spontaneous echocontrast after leaflet grasping (C). LV: left ventricle

Assessment of result before Clip release
The best result should be a proper balance between tolerable transmitral pressure gradient (TMPG) and
adequate reduction of MR.