Three-dimensional echocardiography and mitral valve prolapse diagnosis: New insights into leaflet and cardiac chamber morphology, and annulus dynamics

Objectives: This report will focus on current and future applications of three-dimensional echocardiography in both in the pre-operative (mainly transthoracic three-dimensional echocardiography) and intraoperative (transesophageal three-dimensional echocardiography) evaluation of prolapsed mitral valves. Both qualitative (morphologic) and quantitative advantages of this technique will be highlighted. Moreover, new insights into the morphology and dynamics of the leaflets, cardiac chamber and annulus are discussed. Conclusions: Real-time 3D echocardiography offers distinct advantages over 2D imaging for evaluation of the mitral valve apparatus. It provides a more authentic representation of mitral valve morphology and is useful not only in the pre-operative and post-operative evaluation of patients undergoing mitral valve prolapse surgery, but is already used in several interventional procedures and may facilitate the continuous evolution of new techniques.