TEE views and Pathology

In this chapter we will review the 11 views you will be expected to recognize plus some pathology to help you with pattern recognition. The pathology seen here is explored in other chapters of this website. 

Mid Esophageal 4 Chamber View

To obtain this view the TEE probe is advanced to the 

mid-esophagus behind the LA.

 

The sector depth should be 14cm and omniplane of 0-10°.

Clockwise:

Clip 1. Normal LV and RV function.

Clip 2. Severely Depressed RV and hyperdynamic LV. 

Clip 3. Severely depressed LV and RV function.

Clip 4. Flail of the posterior MV leaflet indicating Severe Mitral Regurgitation

RA                      LA

TV              AMVL       PMVL

         IS                            AL   

 

RV                       LV

  1  

  2  

  3  

  4  

Here we visualize: Left Atrium (LA), Right Atrium (RA), Left Ventricle (LV) [inferoseptal (IS) + anterolateral (AL) walls], Right Ventricle (RV), Mitral Valve [anterior(AMVL), posterior (PMVL) leaflets], Tricuspid Valve [Septal (STVL), Anterior (ATVL) leaflets]

 
 

Mid Esophageal 2 Chamber View

To obtain this view, from ME 4 chamber omniplane to 90°

On these images,

 

Clip 1. Normal Function.

Clip 2. Severely Depressed LV EF. RA also appears enlarged on this view.

           LA

PMVL       AMVL

Inferior                Anterior

              LV

 

Here we visualize: Left Atrium (LA), Left Ventricle (LV) [Anterior and Inferior walls], Mitral Valve [anterior(AMVL), posterior (PMVL) leaflets], coronary sinus (CS).

 

Mid Esophageal Long Axis

To obtain this view, from ME 4 chamber omniplane to 

120-130°

On these images,

Normal function vs

Stuck non coronary or left coronary cusp.

                     LA

PMVL            AMVL

                       LVOT           AV

Inferolat   

                        Antero sept

              LV

Here we visualize: Left Atrium (LA), Left Ventricle (LV)[anteroseptal and inferolateral walls], Mitral Valve [anterior (AMVL), posterior (PMVL) leaflets], Aortic Valve (AV), Left Ventricular outflow tract (LVOT).

 

Mid Esophageal Ascending Aorta Long Axis

To obtain this view from ME 4 long axis withdraw the probe to bring the right pulmonary artery in view.