Mitral valve anatomy and function: new insights from three-dimensional echocardiography

Denisa Muraru, Maria Cattarina, Francesca Boccalini, Carlo Dal Lin, Diletta Peluso, Giacomo Zoppellaro, Roberto Bellu, Cristiano Sarais, Borejda Xhyheri, Sabino Iliceto, Luigi P Badano
Journal of Cardiovascular Medicine 2013, 14 (2): 91-9
Integrating volumetric rendering with motion in real-time, three-dimensional (3D) echocardiography is the most suitable imaging technique for assessing heart valves. Today, the rapidly advancing 3D technology allows us to perform a virtual 'dissection' of the heart intra vitam and to discover unprecedented, realistic views of cardiac valves in just a few minutes. The mitral valve is the cardiac structure easiest to visualize by transthoracic or transoesophageal approach. Three-dimensional echocardiography is able to display the non-planar valve leaflets and annulus, the complex subvalvular apparatus and their spatial relationships with the surrounding structures. The complementary use of 3D colour flow adds data about valve integrity and allows the quantitation of valvular diseases. Accumulating evidence suggests that 3D echocardiography is emerging as the reference technique to assess mitral valve morphology and function and guide valvular procedures of mounting complexity. The purpose of this review is to provide an update on the current clinical applications of 3D echocardiography for assessing mitral valves and to stress the incremental benefits of 3D echocardiography over conventional two-dimensional echocardiography.

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