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. 2014 Sep 15;1(1):e000136. doi: 10.1136/openhrt-2014-000136

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Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Three-dimensional (3D) measurement of the outer and inner/effective mitral annular area. The left panel showing a cropped 3D image of the mitral valve. From this 3D data set, an apical long-axis view of the mitral apparatus was used to determine the anterior and posterior mitral annulus, which was perpendicular to the commissure–commissure view and crossed the centre of the commissure–commissure plane (medial–lateral). The outer and inner borders of the annulus were then manually traced in multiple planes rotated around the axis connecting the centre of the mitral annulus and left ventricular apex, to measure the outer and inner/effective mitral annular area.