Identification of Prolapsing Mitral Valve Scallops by a Three‐Dimensional Multiplanar Reconstruction Method

Background The objectives of this study were twofold: to assess the diagnostic utility of three‐dimensional (3D) multiplanar reconstruction ( MPR ) in identifying prolapsing mitral valve (MV) scallops, and (2) to compare two‐dimensional (2D) transthoracic echocardiography ( TTE ) and 3D MPR to (2D) transesophageal echocardiography ( TEE ) approaches among patients with mitral valve prolapse ( MVP ). Methods Fifty‐five patients with MVP who underwent MV repair or replacement were retrospectively analyzed using 3 types of echocardiographic studies (2D TEE , 2D TTE , 3D MPR ). The operative ( OR ) findings were considered the gold standard. Results When 3D MPR was combined with 2D TTE , the agreement with the OR findings was moderately strong for the A2 scallop (P < 0.001) and strong for the A3 scallop (P = 0.001), entire anterior leaflet (P < 0.001), P2 scallop (P < 0.001) and the entire posterior leaflet (P < 0.001). In comparison to the OR findings, 2D TEE demonstrated moderately strong agreement for the A2 scallop (P = 0.010) and the entire anterior leaflet (P < 0.001), and strong agreement for the P2 scallop (P < 0.001) and entire posterior leaflet (P < 0.001). Conclusions Three‐dimensional MPR should be added to the armamentarium of complementary echo techniques in the evaluation of MVP . There is increased benefit in combining 3D MPR with 2D TTE findings as part of the preoperative evaluation of patients with MVP .