For patients with flail mitral valves, the TEE view should be aligned to demonstrate the maximal excursion of the flail segment (typically mid-esophageal zero degree angulated to show the A2, P2 scallops and/or the long axis view of the left ventricular outflow tract (100-160°) that also shows these scallops). The inter-commissural view (55-75°) may also be helpful. The distance separating the tip of the flail segment from its opposing normally coapting leaflet is termed the flail gap. Leaflet grasping is facilitated when this distance is <10mm (Figures 32, 33). This measurement is readily accomplished with 2D TEE.