Figure 2c from: Cirillo M (2020) Ring-first Mitral Valve Repair. Research Ideas and Outcomes 6: e62369. https://doi.org/10.3897/rio.6.e62369

Figure 2c The two most frequent types of mitral pathology: Barlow's disease (a and b) and fibroelastic deficiency (c and d). The pathological pictures are shown and the advantage of implanting the prosthetic ring before performing the repair of the valve leaflets is illustrated. - In fibroelastic deficiency the mitral annulus is dilated by chronic regurgitation, widening the valvular area and this may induce a quite large (quadrangular, dashed lines) resection;