Table 3.

Descriptions of discrepancies in surgical findings in the surgeons’ own words and level of experience

Level of experience	Comments
Senior independent practitioner, more than 5 y	I underestimated the degree of prolapse from both 2D and 3D, but this would not have changed the surgical approach or intraoperative evaluation.
Senior independent practitioner, more than 5 y	It was more or less what I thought of after the VR assessment. However, I couldn't appreciate much the annulus dilatation and that's why I didn't think of the annuloplasty. Probably is more due to my lack of experience rather than not being seen on VR.
Senior independent practitioner, more than 5 y	The membrane was obviously a bigger player but then the surgeon had to do further subvalvular surgery with papillary muscle splitting, which I felt did need to be done from the images.
Junior trainee, less than 3 y	I thought of implanting neochordae and annuloplasty. There was also a commissural stitch between A3 and P3 that I didn't think of. Probably I didn't assess this segment properly neither on echo nor in VR, but roughly, the approach was quite similar to what I initially thought of.

2D, 2-Dimensional; 3D, 3-dimensional; VR, virtual reality.