 |
| OPEN RING For annular plication (as is usual in the posterior mitral and anterior and posterior tricuspid annulus), larger amounts of tissue (> 3 mm) are incorporated within each horzontal mattress suture loop underneath the suture-platform |
 |
| CLOSED RING For annular plication (as is usual in the posterior mitral and anterior and posterior tricuspid annulus), larger amounts of tissue (> 3 mm) are incorporated within each horzontal mattress suture loop underneath the suture-platform |
 |
| For annular stabilization without plication(as is usual in the anterior mitral annulus), the sutures should incorporate exactly 3 mm of tissue, corresponding to the precise distance between the 2 holes in each suture-platform |
 |
| With the Uniring® free of the holder, slide the Uniring® onto the annulus |
 |
| Once all sutures are placed one-to-one in the Uniring®, cut at the appropriate heat-sealed joints using a sharp blade in the cutting guide on the outside edge of the “first” and “last” suture-platforms |
 |
| Using the suture guides on the holder, place the individual mattress sutures through
the suture-platforms leaving the Uniring® on the holder Use 2/0 sutures (Cardioflon®) for the mitral annulus |
 |
| Place the sizer (with the “M” showing) over the AML with the notches at the commissures With the sizer against the anterior annulus, place the two intercommissural sutures in the annulus corresponding to the desired location of the “first” and “last” suture-platforms as indicated by the half-oval markings on the sizer, depending upon how far around the annulus the surgeon chooses to go |
 |
| Place one suture at each commissure and use lateral traction to straighten the anterior annulus, and place one suture (“middle” suture) in the center of the posterior annulus (P2) Place additional sutures in the annulus if necessary in order to visualize the unfurled anterior mitral leaflet (AML) |
 |
| The number on the right side indicates the total number of suture-platforms needed and therefore the total number of individual mattress sutures required in the annulus Half-oval markings on the sizer represent the position of the suture-platforms on the final dimension of the native annulus |
|
||||||||||||||||||||||||||
