Three-dimensional echocardiographic evaluation of aortic and mitral valve stenosis

Dynamic volume rendered three-dimensional echocardiography allows the spati al recognition. of anatomy and function, of the aortic and mitral valves wi th acceptable image quality. The aortic value can be best visualized in a v iew from the ascending aorta down to the valve level, thus allowing an over view of the aortic aspect of the valve in a surgeon's perspective in simila r to 80% of patients. Planimetric measurement of the aortic valve area was possible in 88% of patients, and there is no systematic overestimation or u nderestimation of aortic valve area compared with two-dimensional echocardi ography and catheterization. The entire valvular circumference of the mitra l valve can be assessed from both a left atrial and a left ventricular pers pective. Advantages of the three-dimensional transesophageal echocardiograp hy mitral valve area determination compared with transthoracic two-dimensio nal planimetry and Doppler-derived pressure half-time method are present in patients with severely calcified mitral valves and in, those with combined aortic regurgitation.