Transthoracic and Transesophageal Echocardiography in the Diagnosis and Management of Mitral Regurgitation

Mitral regurgitation is a common and heterogeneous valve disease, with its prevalence increasing due to aging populations. This review aims to provide a comprehensive overview of the roles of transthoracic (TTE) and transesophageal echocardiography (TEE) in the evaluation of mitral regurgitation (MR).

MR encompasses a spectrum of pathologies, ranging from degenerative leaflet prolapse to functional regurgitation caused by left ventricular remodeling. Accurate assessment of regurgitation is challenging and requires a multiparametric, comprehensive approach. TTE remains the primary imaging modality used to evaluate mitral valve structure, determine the severity of regurgitation, and related hemodynamic effects. TEE provides higher-resolution imaging for more detailed anatomical assessment, particularly valuable in surgical planning and transcatheter mitral procedures. The introduction of 3D echocardiography has further improved mitral valve imaging, allowing accurate preprocedural assessment and real-time guidance during structural interventions.

Both TTE and TEE play essential and complementary roles in the thorough evaluation of MR. A multiparametric approach ensures accurate characterization of the regurgitation severity.

Role of echocardiography in comprehensive characterization of mitral regurgitation. EROA = effective regurgitant orifice area, VC = vena contracta, CW = continuous wave, LA = left atrium, LV = left venricle, MR = mitral regurgitation; MV = mitral valve, PISA = proximal isovelocity surface area; RF = regurgitant fraction, R Vol = regurgitant volume,

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