The Normal Mitral Valve

Accurate characterization of the normal anatomy and function of the mitral valve apparatus is key to understand the pathophysiology of mitral valve diseases. Echocardiography is the first-line imaging technique used for the assessment of the mitral valve morphology and function. During the last five decades, echocardiography has evolved from M-mode to two-dimensional, and then three-dimensional imaging, introducing a new era in the cardiovascular imaging. The use of newly matrix array transthoracic and transesophageal transducers bestowed unique possibilities to assess the mitral valve apparatus in all three or four-dimensions (including time), without the need of offline reconstruction. Heart imagers were able to obtain for the first time “en face” visualization of the mitral valve from the atrial perspective, as only the surgeons were previously able to see it, and to describe in detail the complex anatomy of the valvular and sub-valvular apparatus.