Mitral regurgitation (MR) is the most commonly found valvular lesion in echocardiography laboratories. Moderate and severe mitral regurgitation have proven to be associated with increased morbidity and mortality, and surgical reconstruction is recommended in severe cases whenever feasible. Three-dimensional echocardiography (3DE) is superior to conventional echocardiography in the detailed assessment of the specific anatomical features and the pathomechanism of MR, and in the accurate grading of its severity. 3DE is adept in detecting and quantifying geometric distortion of the mitral annulus and analysing valve mechanics. Segmental analysis of leaflet pathology is considerably facilitated and quantification software packages offer new parameters for tailored surgical repair techniques. Direct visualization of the anatomic regurgitant orifice and calculations of the effective regurgitant orifice area by 3D color Doppler techniques promise to circumvent the limitations of conventional echocardiography in the quantification of mitral regurgitation.
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