Assessment of valvular regurgitation with Doppler echocardiography

The severity of MR can be assessed by several parameters using echocardiography. Two-dimensional echocardiography provides an indirect assessment with such findings as enlarged ventricles, dilated left atrium, and structural abnormalities of the mitral valve (e.g., prolapse or flail leaflets). Color Doppler then is applied, and the extent and direction of the jet in the left atrium as well as the size of the vena contracta are evaluated to render a semiquantitative evaluation. Finally, calculation of the regurgitant orifice area, regurgitant volume, and regurgitant fraction is possible using a combination of two-dimensional and pulsed Doppler measurements. The PISA method can be used to corroborate the aforementioned calculations. The use of these three different methods helps to increase the confidence in the data deduced by any one method, particularly in difficult and borderline cases.