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A B C
Figure 11. Favorable MV anatomy for chordal implantation: isolated P2 prolapse (A). Unfavorable MV anatomy: (B) bileaflet multiscallop
prolapse; and (C) commissural prolapse. MV: mitral valve
Among imaging modalities, invasive venography is the gold standard for the assessment of coronary
sinus anatomy; moreover, simultaneous coronary angiography allows assessment of the relation with the
[48]
coronary arterial tree .
PREPROCEDURAL PLANNING FOR MITRAL CHORDAL IMPLANTATION
Transapical chordal implantation using the NeoChord DS1000 system (NeoChord, Inc., Minnesota,
USA) or Harpoon (Edwards Lifescience, California, USA) is a minimally invasive MV repair procedure
addressing the correction of isolated prolapse or flail of the posterior leaflet in patients without significant
[49]
annular dilatation . The aims of the preprocedural assessment are: (1) ascertain that patients meet some
