The Mitral Valve by Three-Dimensional Echocardiography

A comprehensive evaluation of patients with mitral valve disease must include an echocardiographic examination of the mitral valve apparatus and resultant hemodynamic changes due to mitral pathology. Three-dimensional echocardiography has impacted on the diagnosis of mitral valve prolapse but has mostly existed in a research realm. After decades of development, three-dimensional echocardiography is now easily performed and readily incorporated in the assessment of mitral valve disease in daily clinical practice. Unique anatomic views of the mitral valve, accurate quantitative assessment of the mitral valve orifice area, and delineation of segmental prolapse are several advantages of three-dimensional echocardiography. Moreover, there is a wealth of data that can be derived from a three-dimensional volume, enabling more detailed analysis of mitral valve apparatus and valve annular dynamics. This review highlights current applications of three-dimensional echocardiography in the routine evaluation of mitral valve disease.     

Mitral Annular Disjunction of Degenerative Mitral Regurgitation: Three-Dimensional Evaluation and Implications for Mitral Repair

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动态三维超声心动图评价二尖瓣关闭不全

本文采取经胸壁及经食道旋转扫描方法获取二维数据，利用总体重建法（ＶｏｌｕｍｉｃＲｅｎｄｅｒｉｎｇＤｉｓｐｌａｙ）对１２例正常人二尖瓣，１４例风心病二尖瓣关闭不全，２０例二尖瓣脱垂患者的二尖瓣解剖结构及二尖瓣返流束进行了动态三维超声心动图重建。重建图像能从左室或左房侧显示二尖瓣装置的整体三维空间结构及动态变化。正常二尖瓣叶光滑平软，舒张期瓣口充分开放，收缩期前后叶对合良好。风心病二尖瓣关闭不全患者瓣叶增厚，收缩期前后叶之间出现裂缝。二尖瓣脱垂时瓣叶某一部分呈“瓢匙”样向左房侧脱出。动态三维超声心动图还能显示二尖瓣关闭不全血液返流束的立体形态及在左房内的空间走向。初步经验表明动态三维超声心动图对二尖瓣关闭不全的诊断有重要临床价值