TEE - standard imaging views

From ECHOpedia
Transesophageal Echocardiographic imaging views. Adapted from Shanewise et al.
[1]
Transesophageal Echocardiographic Anatomy
ME two-chamber Probe adjustment: neutral Sector depth: ~14 cm
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
Primary diagnostic issues
Mitral valve pathology
LVOT pathology
Required structures
LV
Mitral valve
LVOT
ME mitral commissural Probe adjustment: neutral Sector depth: ~12 cm
Primary diagnostic issues
Localization of mitral valve
pathology
Required structures
Mitral valve (P
1
, P
3
and A
2
scallops)
Papillary muscles/chordae tendineae
LA
LV
TG mid-SAX Probe adjustment: neutral Sector depth: ~12 cm
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
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
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
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
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
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
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
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1. Shanewise JS, Cheung AT, Aronson S, Stewart WJ, Weiss RL, Mark JB, Savage RM, Sears-Rogan P, Mathew JP,
Quiones 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.