The role of three-dimensional echocardiography for the clinical diagnosis and management of mitral valve disease

Echocardiography plays a central role in the characterization of the mitral valve (MV) morphology and function. In the past decade, the development of three-dimensional echocardiography (3DE) has revolutionized valvular imaging, becoming the technique of choice for an accurate evaluation of the MV anatomy and pathophysiology. Transthoracic and transoesophageal 3DE represent complementary imaging techniques to assess the complex MV apparatus in the beating heart, to plan interventions, to monitor transcatheter procedures (e.g. MitraClip, mitral valve balloon valvuloplasty, and paravalvular leak closure) and to assess the results of surgical repair. The aim of this article is to review the contribution of 3DE in evaluating the anatomy and function of the MV apparatus in a variety of MV diseases, highlighting the current clinical applications of this essential echocardiography technique.