Mitral Valve

Abstract

This chapter describes each component of the mitral valve (MV) apparatus by echocardiographic evaluation and discusses how all components act together in accomplishing efficient valve closure and opening. A standard echocardiographic examination of the MV consists of multiple two-dimensional views and a Doppler flow evaluation. Together, these elements form an integrated examination of the MV that can reliably define its function and evaluate the severity of abnormalities. The different forms of disease are described: mitral regurgitation, which can be due to abnormalities of leaflets, chordae, papillary muscles or mitral annulus, and mitral stenosis. For this evaluation the standard approach is employed, using the same views as used in the morphological examination of the MV. Quantification requires a Doppler technique with qualitative (spectral Doppler echocardiography), semiquantitative (color Doppler echocardiography) and quantitative (regurgitation volume, regurgitation area, regurgitation fraction) assessments. Finally, we review real-time three-dimensional echocardiography, a new technique improving the imaging of MV anatomy and allowing a more complete evaluation of its diseases.