1. TTE is recommended as the first-line imaging modality in valvular regurgitation.
2. TEE is advocated when TTE is of non-diagnostic value or when further diagnostic refinement is required.
3. 3D TEE or TTE is reasonable to provide additional information in patients with complex valve lesion.
4. TEE is not indicated in patients with a good-quality TTE except in the operating room when a valve surgery is performed.