3DE of Normal Mitral Valve: Image Display and Anatomic Correlations

Understanding normal anatomy of the mitral valve (MV) is of paramount importance for a correct interpretation of the wide spectrum of MV diseases and for safe and effective surgical and percutaneous transcatheter procedures targeting the mitral annulus and leaflets. In the past two decades, technological advances in non-invasive imaging techniques have allowed acquisition of exquisite anatomical details of the heart in both two-dimensional (2D) and three-dimensional (3D) format. This chapter will focus on the normal gross anatomy of the MV as provided by three-dimensional transesophageal echocardiography (3D TEE). However, other non-invasive imaging techniques, in particular computed tomography (CT) and cardiac magnetic resonance (CMR), may visualize specific components of the mitral valve apparatus and surrounding structures with more details than 3D TEE, and these techniques are nowadays indispensable companions of 3D TEE for an accurate and complete description of the MV apparatus.