Figure 6. Longitudinal plication of the anterior mitral leaflet Left: Anterior leaflet plication viewed from the aortotomy. Interrupted sutures are placed in the anterior leaflet starting at the distal portion of the leaflet, near its attachment with the chordae, with additional sutures placed longitudinally towards the annulus depending on changes in mobility. Reproduced from McIntosh CL et al, Circulation 1992;86:II60-7. Right: Another depiction of longitudinal anterior leaflet plication. Here sutures are placed more centrally in the leaflet, still in a longitudinal orientation.