Three-Dimensional Echocardiographic Imaging of Secondary Mitral Valve Regurgitation

  • Raluca Dulgheru
  • Paaladinesh Thavendiranathan
  • Khalil Fattouch
  • Mani Vannan
  • Patrizio LancellottiEmail author


Many hypotheses regarding the mechanism of secondary mitral regurgitation (SMR) have been made from 2D echocardiographic observations. Some have been confirmed and further developed with the help of 3D echocardiography (Otsuji et al., Circulation 96:1999–2008; Otsuji et al., J Am Coll Cardiol 37:641–8, 2001). 3D echocardiography, and especially 3D transesophageal echocardiography (TEE), has much to offer in the evaluation of SMR, in addition to 2D echocardiography. First, it offers important information regarding MV geometry, giving insights into the mechanisms involved in the genesis of SMR in each patient. Second, it can improve the accuracy of MR quantification (Chandra et al., Am J Physiol Heart Circ Physiol 301:H1015–24, 2011; Hyodo et al., J Am Coll Cardiol Img 5:669–76, 2012). Third, it can play an important role in the planning of surgery or percutaneous intervention.


Mitral Annulus Regurgitant Volume Vena Contracta Regurgitant Orifice Effective Regurgitant Orifice Area 
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Supplementary material

Movie 5.1

3D Zoom mode acquisition of the mitral valve as seen from the atrial perspective (“surgeon’s view) by 3D transoesophageal echocardiography. The displayed image is then rotated in such a way that the aorta is located anteriorly. (AVI 5579 kb)

Movie 5.2

3D Zoom mode acquisition of the mitral valve as seen from the ventricular perspective by 3D transoesophageal echocardiography. The displayed image is then rotated in such a way that the anterior mitral leaflet is seen opening in diastole towards the interventricular septum, while the posterior leaflet is almost fixed during the cardiac cycle. (AVI 3927 kb)

313059_1_En_5_MOESM3_ESM.avi (3.5 mb)
Movie 5.3 Full Volume Color Flow Doppler Gated Acquisition with 3D transoesophageal echocardiography in a patient with ischemic mitral regurgitation and a centrally oriented regurgitation jet, indicative of symmetric tethering pattern. (AVI 3628 kb)


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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Raluca Dulgheru
    • 1
  • Paaladinesh Thavendiranathan
    • 2
  • Khalil Fattouch
    • 1
    • 2
  • Mani Vannan
    • 2
  • Patrizio Lancellotti
    • 1
    Email author
  1. 1.Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve ClinicUniversity of Liège, University Hospital Sart TilmanLiègeBelgium
  2. 2.Peter Munk Cardiac CenterUniversity Health Network, Toronto General Hospital, University of TorontoTorontoCanada

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