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Figure 3: (a) "Early in systole, flow drag is the dominant hydrodynamic force on the mitral leafl ets. After the mitral-septal contact, the pressure difference (gradient) is the force that pushes the mitral leaflet further into the septum". (b) The prominent midseptal bulge redirects outflow so that it comes from a relatively posterior direction, catching the anteriorly positioned mitral valve and pushing it into the septum. After extended myectomy, flow tracks more anteriorly and medially, away from the mitral leafl ets (reprinted with permission from Sherrid and Arabadjian[33] from Elsevier Inc.)

Figure 3: (a) [33] from Elsevier Inc.)">