Two and three dimensional echocardiography for pre-operative assessment of mitral valve regurgitation

Abstract

Mitral regurgitation may develop when the leaflets or any other portion of the apparatus becomes abnormal. As the repair techniques for mitral valve disease evolved, so has the need for detailed and accurate imaging of the mitral valve prior to surgery in order to better define the mechanism of valve dysfunction and the severity of regurgitation. In patients with significant mitral valve disease who require surgical intervention, multiplane transesophageal echocardiogram (TEE) is invaluable for surgical planning. However, a comprehensive TEE in a patient with complex mitral valve disease requires great experience and skill. There is evidence to suggest that 3D echocardiography can overcome some of the limitations of 2D multiplane TEE and thus is crucial in evaluation of patients undergoing mitral valve surgery. In the following sections, we review some of the crucial 2D and 3D echo images necessary for evaluation of MR based on the Carpentier classification.

An easy‐to‐use scoring index to determine severity of mitral regurgitation by 2D echocardiography in clinical practice

“…Thus, despite studies revealing validity and utility of ERO and related parameters in a research setting, our study confirms the results showing variable feasibility in a clinical setting . As in the study of Quader et al., we showed that E‐wave velocity was not sensitive enough to exclude severe MR, therefore not useful as a screening tool. Regarding the qualitative measurements, both jet characteristics and SR contributed more to the final score.…”

Echocardiographic quantification of mitral apparatus morphology and dynamics in patients with dilated cardiomyopathy

“…Some patients with ischemic DCM may develop more focal LV remodeling, such as that following myocardial infarction (MI), and the PMs can therefore be unequally damaged. 21 MV tethering is usually symmetric in patients with global LV dysfunction and remodeling, with increased LV sphericity. The MR jet is central in patients with global wall motion abnormalities, with equal lateral displacement of the PMs, similar to nonischemic cardiomyopathy 21 (Figure 3 might occur in patients with multiple vessel disease and old inferior MI, mainly affecting the posterior PM.…”

Ecocardiografía avanzada: aplicación clínica actual del análisis de deformación miocárdica y de la imagen tridimensional

“…Válvula mitral.-La valoración de la compleja anatomía y función mitral se realiza con imágenes adquiridas en el modo zoom, lo que permite utilizar la máxima resolución temporal y espacial (Quader et al 2014, Buck y Plitch 2015. El mayor avance respecto a las técnicas 2D, es la posibilidad de observar la válvula desde una perspectiva frontal, bien desde el VI o desde la aurícula izquierda (AI).…”