Fall, 2009
 
The article, “Three-dimensional Versus Two-dimensional Transesophageal Echocardiography in Mitral Valve Repair”, presents a study that occurred between the years of 2002 and 2004.  This study included 81 surgical candidates for mitral valve repair or replacement.  The patients involved with the study were patients under the age of 80, patients that did not require emergency surgery, patients without active endocarditis, and patients without disease that would affect the prognosis (Azpitarte et al.2007 p.5).   In order to set a constant standard for all 81 patients, surgical protocols were developed for both two-dimensional and three-dimensional imaging. 
 
One of the most important issues with surgical candidates is “accurate knowledge of the morphology and function of the affected mitral valve” (Azpitarte et al.2007 p.4).   Two-dimensional Transesophageal l Echocardiograms (TEE’s) are usually used prior to surgery to evaluate the affected mitral valve.  In this study both two-dimensional and three-dimensional images were acquired in order to compare the accuracy and value of both.  One goal of the study was to prove or disprove the benefits of Three-dimensional TEE’s assessment of the mitral valve.  
 
Research showed that both 2 dimensional and 3 dimensional had advantage and disadvantages.  One disadvantage of the three-dimensional TEE’s is the increase of time it takes to acquire and reconstruct the images.  Also, both probes varied in accuracy when dealing with different segments of the anterior and posterior leaflets.  Both were most accurate  when evaluating the P2 segment and less accurate with the P3 segment of the posterior mitral valve leaflet.  Three-dimensional was more accurate than two-dimensional when assessing the A1 segment of the anterior mitral valve leaflet.   “In most cases, the inaccuracies of the three-dimensional images were caused by technical problems” (Azpitarte et al.2007 p.11).
In conclusion, the research data indicated that three-dimensional echocardiography is and can be beneficial when evaluating the mitral valve. One major benefit found in the study was the ease of interpretation of the three-dimensional images, even to an inexperienced observer.  In the future protocols may include three-dimensional to be used in addition to two-dimensional imaging. Various other studies are being done throughout the medical field on this same topic which will provide more data and support for whether three-dimensional or two-dimensional is more beneficial in mitral valve repair.  Until then two-dimensional will still be the standard used in most surgical cases.

References
Azpitarte ,J., García-Fernándezd ,M.A., García-Orta ,R., Lara ,J.,  Moreno, E., & Moreno T., et al. (2007).Three-dimensional Versus Two-dimensional Transesophageal Echocardiography in Mitral Valve Repair.  Journal of the American Society of Echocardiography, 20(1), 4-12.