3-D Echocardiography in Balloon Mitral Valvuloplasty

3-D echocardiography by volume rendering allows visualisation of tde mitral valve en face eitder from tde left atrium or tde LV. Applebaum et al. evaluated tde mechanism of balloon valvuloplasty by 3-D echocardiography.(16) Volume rendered 3-D images enabled visualisation of commissural splitting and leaflet tears not seen witd 2-D (see Figure 7 and 8). tdey found tdat balloon mitral valvuloplasty was more successful when complete splitting was achieved compared witd partial splitting. Moreover, in 38% of patients in whom an increase of mitral regurgitation developed, tear was visualised by 3-D. Langerveld et al. conducted a similar study, where 3-D TOE enabled a better description of tde mitral valvular anatomy following balloon mitral valvuloplasty, compared witd 2-D echocardiography. In addition, significant relation of mitral valve volume before valvuloplasty to a successful procedure was found.(17)

Figure 7: Diastolic Frames of tde 3-D Reconstruction of tde Mitral Valve Orifice

Seen from tde left atrium before (A) and after (B) balloon valvuloplasty. A posteromedial commissural split is visualised (arrow).(17)

Figure 8: Diastolic Frames of tde 3-D Reconstruction of tde Mitral Valve Orifice

Seen from tde left atrium before (A) and after (B) balloon valvuloplasty. A posteromedial (white arrow) and anterolateral (black arrow) commissural split is visualised.(17)

Mitral Valve Prolapse

Echocardiography is tde most utilised imaging modality for diagnosis of mitral valve prolapse. Mmode and 2-D echocardiography frequently lead to false-positive and false-negative diagnoses due to tde non-planar leaflet–annular relationships of tde mitral valve. Prolapse is generally defined as a displacement of a bodily part from its normal position or relations. By 3-D echocardiography it is possible to visualise tde mitral valve en face from eitder tde left atrium or tde LV.(18,19) In volume rendered images looking down in tde left atrium, mitral valve prolapse is viewed as a convexity or bulge and often