Usefulness of 3D Transthoracic Echocardiography to Clarify and Display the Mechanism of Mitral Regurgitation
by Denisa Muraru, MD, PhD
Department of cardiac, thoracic and vascular sciences, University of Padua, School of Medicine, Padua, Italy
Two-dimensional PSAX view, with and without color Doppler, confirming the presence of eccentric MR jet with unclear origin.
Since the mechanism of MR was still unclear after performing a standard 2D echo study of the MV, a 6-beat 3D dataset of the LV (including the MV) was acquired from the apical approach for 2 purposes: 1. MV reconstruction; 2. LV quantification.
If still unsure about the presence and localization of the prolapse from the surgical view (in which small prolapses are more difficult to identify by less experienced readers), one trick is to use the “parallel cropping” mode which eliminates the irrelevant structures from the far field and enhances the color gradient of the LV rendering, so that closer structures, i.e. prolapsing segment is colored differently (bronze) than the rest of the valve (blue, since it lies at a deeper level).
The LV quantitative analysis showed a mildly dilated LV (3D EDV=87 ml/m2) with normal EF (65%). Doppler criteria were supportive of moderate-severe MR. The patient was confirmed to be asymptomatic at exercise echo and close follow-up was recommended.