TEE - standard imaging views

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Transesophageal Echocardiographic imaging views. Adapted from Shanewise et al. [1]

Transesophageal Echocardiographic Anatomy
ME two-chamber Probe adjustment: neutral Sector depth: ~14 cm
ME two-chamber.svg
Primary diagnostic issues
  • LA appendage
  • Mass/thrombus
  • LV apex pathology
  • LV systolic dysfunction (apical segments)
Required structures
  • LA appendage
  • Mitral valve
  • LV apex (i.e., maximal LV length)
ME LAX Probe adjustment: neutral Sector depth: ~12 cm
ME LAX.svg
Primary diagnostic issues
  • Mitral valve pathology
  • LVOT pathology
Required structures
  • LV
  • Mitral valve
  • LVOT
ME mitral commissural Probe adjustment: neutral Sector depth: ~12 cm
ME mitral commissural.svg
Primary diagnostic issues
  • Localization of mitral valve pathology
Required structures
  • Mitral valve (P1, P3 and A2 scallops)
  • Papillary muscles/chordae tendineae
  • LA
  • LV
TG mid-SAX Probe adjustment: neutral Sector depth: ~12 cm
TG mid SAX.svg
Primary diagnostic issues
  • Hemodynamic instability
  • LV enlargement
  • LV hypertrophy
  • LV systolic dysfunction (global and regional)
Required structures
  • LV cavity
  • LV walls (at least 50% of circumference with visible endocardium)
  • Papillary muscles (approximately equal in size and distinct from ventricular wall)
TG two-chamber Probe adjustment: neutral Sector depth: ~12 cm
TG two-chamber.svg
Primary diagnostic issues
  • LV systolic dysfunction (anterior and inferior basal segments)
Required structures
  • Mitral leaflets
  • Mitral subvalvular apparatus
  • LV (anterior and inferior: basal plus mild segments)
TG RV inflow Probe adjustment: neutral-rightward Sector depth: ~12 cm
TG RV inflow.svg
Primary diagnostic issues
  • RV systolic dysfunction
  • Tricuspid valve pathology
Required structures
  • Tricuspid leaflets
  • Tricuspid subvalvular apparatus
TG RV inflow-outflow Probe adjustment: neutral-rightward Sector depth: ~14 cm
TG RV inflow-outflow.svg
Primary diagnostic issues
  • RV systolic dysfunction
  • RVOT pathology
  • Pulmonary artery pathology
  • Pulmonic valve evaluation
Required structures
  • RA
  • RV
  • Main pulmonary artery
  • Pulmonic valve
TG basal SAX Probe adjustment: neutral Sector depth: ~12 cm
TG basal SAX.svg
Primary diagnostic issues
  • LV systolic dysfunction (basal segments)
  • Mitral valve pathology
Required structures
  • Mitral leaflets
  • Mitral subvalvular apparatus
  • LV (basal segments)
TG LAX Probe adjustment: neutral-leftward Sector depth: ~12 cm
TG LAX.svg
Primary diagnostic issues
  • LV systolic dysfunction (anteroseptal and posterior: basal segments)
  • Doppler evaluation of aortic valve
Required structures
  • Mitral leaflets
  • Mitral subvalvular apparatus
  • LV (anteroseptal and posterior: basal plus midsegments)
  • Aortic valve
Deep TG LAX Probe adjustment: neutral Sector depth: ~16 cm
Deep TG LAX.svg
Primary diagnostic issues
  • Aortic valve pathology
  • LVOT pathology
  • Doppler evaluation of aortic valve
Required structures
  • LV
  • Aortic valve
  • Aorta
  • ME, midesophageal; Asc, ascending; SAX, short axis; LAX, long axis; UE, upper esophageal; Desc, descending; AV, aortic valve; RV, right ventricular; LVOT, left ventricular outflow tract; RA, right atrium; LA, left atrium; LV, left ventricular; RVOT, right ventricular outflow tract; TG, transgastric.

References

  1. Shanewise JS, Cheung AT, Aronson S, Stewart WJ, Weiss RL, Mark JB, Savage RM, Sears-Rogan P, Mathew JP, Quiñones MA, Cahalan MK, and Savino JS. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography. Anesth Analg 1999 Oct; 89(4) 870-84. pmid:10512257. PubMed