Tricuspid
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

Tricuspid
Tie each mattress
suture firmly with 7 knots

Tricuspid
Using the suture guides on the holder, place the individual mattress sutures through the suture-platforms leaving the Uniring® on the holder. The “first” suture should be placed in the vertical part of the anterior annulus just above the anterior-septal commissure Use 2/0 or 3/0 sutures Cardioflon®) for the
tricuspid annulus

Tricuspid
Place the sizer (with the “T” showing) over the unfurled anterior tricuspid leaflet (ATL) with the notches at each end of the septal leaflet Choose the sizer which best approximates the surface area of the ATL.
With the straight side of the sizer against the septal annulus, place the “last” suture in the septal annulus corresponding to the location of the last half-oval marking before the open space
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IMPLANTATION TECHNIQUE

• There must be a 3 mm space of tissue between individual mattress sutures to accomodate the flexible joints of Uniring®

• Individual braided polyester horizontal mattress sutures are placed one-to-one in the tissue annulus corresponding to the number of suture-platforms needed

• The gaps between the “middle” sutures and the “first” and “last” sutures, (and any additional suture used for exposure of the anterior leaflet), should be made up with the exact number of sutures according to the total number of suture-platforms indicated on the sizer