Additional reduction of the leaflet height could be achieved by folding the leaflet edge toward the ventricle before deploying the U- clip. The remaining loops were distributed at equal distance along the edge of the prolapsed segment by applying the same technique. After the pledget platform was secured, the 2 free suture needles were placed through the anterior prolapse. The correct apposition was confirmed with saline test. The assistan, at the patient side, tied the knots. Annuloplasty was performed at the surgeon's discretion. For concomitant left atrial ablation a SurgiFlex XL probe was applied endocardially. Lastly the heart was de-aired and.
