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thickening and calcification or with significant sub valvular scarring to warrant mitral valve replacement.
Nowadays the evaluation and grading of mitral regurgitation is eminently echocardiographic. Although
the distinction between mild and severe grade of mitral regurgitation using echocardiography is easy, it
is not the same for the cases of intermediate (II and III) grades. Doppler echocardiography is dependent
on hemodynamic parameters such as the preload, afterload, and rhythm, anatomic parameters such as the
dimensions of left atrium, technical parameters such as the “window”, and operator’s experience. Thus,
echocardiographic evaluation of mitral regurgitation severity should be done using an integrative approach
that incorporates multiple parameters, including semi-quantitative measures (vena contracta width or area)
and quantitative measures (effective regurgitant orifice area, regurgitant volume, and regurgitant fraction).

DECLARATIONS
Authors’ contributions
The author contributed solely to the article.

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
The author declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

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