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A, The central free margin plication technique is used to recreate an adequate leaflet coaptation area by plicating the prolapsed cusp toward the annulus. B, A paracentral plication technique can also be performed by plicating the cusp closer to the commissure. C, Commissuroplasty can be performed asymmetrically by pulling the plication toward one of the commissures to realign the free margin of the prolapsed cusp.
