Assessment of mitral regurgitant jets by three-dimensional color Doppler

Background. Color Doppler echocardiography is a standard technique for asse ssing mitral regurgitation before and after mitral valvuloplasty. Mitral va lve prolapse produces complex eccentric jet flows that cannot be visualized and measured by two-dimensional color Doppler echocardiography. The aim of this study was to evaluate the clinical impact of three-dimensional color Doppler echocardiography, a new technique developed at our institution for assessing mitral regurgitation. Methods. Forty-five patients with mitral regurgitation underwent intraopera tive transesophageal echocardiography and three-dimensional Doppler data ac quisition The grade of mitral regurgitation was assessed by angiography. Th e jet areas were calculated by planimetry from conventional color Doppler; the jet volumes were obtained by three-dimensional Doppler data, Results. New patterns of mitral regurgitant flows were recognized according to the origin, direction, and spatial spreading into the left atrium. Conv entional jet areas failed to separate the groups of patients with different degrees of regurgitation, whereas the jet volumes were able to divide pati ents with different regurgitation grades. No significant correlation was fo und between jet area and angiographic grading (r = 0.63, p = NS). Jet volum es were significantly correlated to angiography (r = 0.89, p < 0.001). Conclusions. Three-dimensional color Doppler echocardiography revealed new patterns of regurgitant now and allowed a more accurate semiquantitative as sessment of complex asymmetrical regurgitant jets. (C) 1999 by The Society of Thoracic Surgeons.