Three-dimensional echocardiography for assessment of mitral valve stenosis

Since the last few years, three-dimensional echocardiography (3DE) has become an accurate tool for mitral stenosis assessment. We will review the latest developments of 3DE in this matter.

Accuracy of 3DE planimetry is superior to the accuracy of the invasive Gorlin's method for mitral valve area (MVA) measurements when a median value obtained from two-dimensional planimetry, pressure half-time, and proximal isovelocity surface area method is used as the gold standard. 3DE improves MVA measurement particularly in less experienced operators compared with experienced operators. 3DE also improves the measurement of MVA in patients with calcific mitral stenosis by means of colour planimetry of the flow stream. Comparison of mitral valve volumes measured by 3DE in patients with critical and without critical stenosis has shown significantly larger volumes in patients with critical stenosis.

Currently, there is sufficient evidence that 3DE is superior to two-dimensional echocardiography and may be routinely used in the quantification of the MVA in mitral stenosis. In the coming years, 3DE might replace Gorlin's method as the gold standard for MVA quantification and may eventually make cardiac catheterization unnecessary.