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Changes of the bivalvation procedure. (A) Suturing free edge of ABL and PBL (Alfieri stitch). (B) ‘Bridging’ using ePTFE tube (reduction of diameter between ABL and PBL). (C) ‘Bridging’ by suturing IAS remnant (reduction of diameter between ABL and PBL). ABL: anterior bridging leaflet; PBL: posterior bridging leaflet; RML: right mural leaflet; LML: left mural leaflet; IAS: interatrial septum; IVS: interventricular septum.
