Dimensional Imaging

Multiplane TEE is now the most commonly used technology. The multiplane probe can scan the entire field from O0 to 1800 , and thus a thorough evaluation of the structures and functions of the heart, including the valves, and the great vessels can be accomplished.

1. The transverse position (at 00 ) is used to image: the basal short axis of the great vessels, the aortic valve, and the left atrial appendage

2. The long axis of the of the heart at various levels to view the chambers, the interventricular septum, tricuspid and mitral valves, the left ventricular outflow tract, and the coronary sinus.

3. The transgastric short axis of the heart is used to view the mitral and tricuspid valves and the left and right ventricles at the basal level, the papillary muscles at the mid short axis level, and the left ventricular outflow tract, ascending aorta, arch, and aortic valve at the deep transgastric level.

The distal aortic arch and the descending thoracic aorta (short axis). The short axis view of the descending thoracic aorta will also image a left pleural effusion.

4. The multiplane scan (>00 to about 1600 ) is used to image:

The short axis at the level of the aortic arch, which also images the pulmonary artery, the pulmonic valve, and the left brachiocephalic vein. The left side of the heart, including the left atrium, left ventricle, left atrial appendage, left upper pulmonary vein, mitral and aortic valves, left ventricular outflow tract, ascending aorta, and coronary sinus. The right side of the heart, including the right atrium, right ventricle, tricuspid and pulmonary valves, right ventricular outflow tract, and pulmonary artery.

The short axis view at the level of the aortic valve, at which the aortic valve, coronary ostia, pulmonic valve, and the interatrial septum are imaged.

The long axis view at the level of the aortic valve, at which the proximal ascending aorta and right pulmonary artery can be imaged in addition to the left ventricular outflow tract and aortic valve. The bicaval view, where the right and left atria, the superior and inferior vena cavae, and interatrial septum are imaged. The long axis of the ascending aorta, which images the right pulmonary artery as well as the ascending aorta.

The long axis of the descending aorta, which will image left pleural effusions.

The transgastric two chamber view, imaging the left atrium and ventricle, mitral valve, chordae, and papillary muscles; the transgastric long axis view imaging the left ventricular outflow tract and the aortic and mitral valves; and the transgastric view of the right ventricular inflow, imaging the right atrium and ventricle, the tricuspid valve and chordae, and papillary muscles.

TEE is used routinely during cardiac valve repair/replacement surgeries to assess the degree of valve damage and malfunction immediately before and the presence of residual abnormalities after the procedure. TEE is also used frequently to continuously monitor regional wall motion and diastolic function.

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