Conclusions
The AutoMVQ analysis is feasible in TTE and TOE examinations of the MV, applicable in patients who need to be treated surgically or with transcatheter therapies. The level of agreement of all mitral annulus measurements between TTE and TOE is strong enough to allow for the less invasive TTE diagnostic method for our patients and give the option for annulus assessment in patients with contraindications for cardiac CT or TOE. However, when a more extensive anatomical and functional MV interrogation is deemed necessary for proper decision making, and the patient’s characteristics allows it, TOE should be preferred over TTE. Further clinical studies with large series of cases are needed in order to establish 3D TTE as an accurate and reproducible method for annulus assessment compared to TOE.