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   </ul>
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|-
! TG RV inflow-outflow
| Probe adjustment: neutral-rightward
| Sector depth: ~14 cm
|-
| image
| valign="top" | Primary diagnostic issues
  <ul>
      <li>RV systolic dysfunction</li>
      <li>RVOT pathology</li>
      <li>Pulmonary artery pathology</li>
      <li>Pulmonic valve evaluation</li>
  </ul>
| valign="top" | Required structures
  <ul>
      <li>RA</li>
      <li>RV</li>
      <li>Main pulmonary artery</li>
      <li>Pulmonic valve</li>
  </ul>
|-
! TG basal SAX
| Probe adjustment: neutral
| Sector depth: ~12 cm
|-
| image
| valign="top" | Primary diagnostic issues
  <ul>
      <li>LV systolic dysfunction (basal segments)</li>
      <li>Mitral valve pathology</li>
  </ul>
| valign="top" | Required structures
  <ul>
      <li>Mitral leaflets</li>
      <li>Mitral subvalvular apparatus</li>
      <li>LV (basal segments)</li>
  </ul>
|-
! TG LAX
| Probe adjustment: neutral-leftward
| Sector depth: ~12 cm
|-
| image
| valign="top" | Primary diagnostic issues
  <ul>
      <li>LV systolic dysfunction (anteroseptal and posterior: basal segments)</li>
      <li>Doppler evaluation of aortic valve</li>
  </ul>
| valign="top" | Required structures
  <ul>
      <li>Mitral leaflets</li>
      <li>Mitral subvalvular apparatus</li>
      <li>LV (anteroseptal and posterior: basal plus midsegments)</li>
      <li>Aortic valve</li>
  </ul>
|-
! Deep TG LAX
| Probe adjustment: neutral
| Sector depth: ~16 cm
|-
| image
| valign="top" | Primary diagnostic issues
  <ul>
      <li>Aortic valve pathology</li>
      <li>LVOT pathology</li>
      <li>Doppler evaluation of aortic valve</li>
  </ul>
| valign="top" | Required structures
  <ul>
      <li>LV</li>
      <li>Aortic valve</li>
      <li>Aorta</li>
  </ul>
|-
| colspan="3" |
<ul>
<li>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.</li>
<li>Modified from Miller JP, Lambert SA, Shapiro WA, et al. The adequacy of basic intraoperative transesophageal echocardiography performed by experienced anesthesiologist. <em>Anesth Analg</em> 2001;92:1103&ndash;1110, with permission.</li>
</ul>
|}
|}
[[File:deep TG LAX.svg|thumb|left|300px]]
[[File:desc aortic LAX.svg|thumb|left|300px]]
[[File:desc aortic SAX.svg|thumb|left|300px]]
[[File:ME asc aortic LAX.svg|thumb|left|300px]]
[[File:ME asc aortic SAX.svg|thumb|left|300px]]
[[File:ME AV LAX.svg|thumb|left|300px]]
[[File:ME AV SAX.svg|thumb|left|300px]]
[[File:ME bicaval.svg|thumb|left|300px]]
[[File:ME four chamber.svg|thumb|left|300px]]
[[File:ME LAX.svg|thumb|left|300px]]
[[File:ME mitral commissural.svg|thumb|left|300px]]
[[File:ME RV inflow-outflow.svg|thumb|left|300px]]
[[File:ME two-chamber.svg|thumb|left|300px]]
[[File:TEE coronary region.svg|thumb|left|300px]]
[[File:TEE LV Sections.svg|thumb|left|300px]]
[[File:TEE mitral valve.svg|thumb|left|300px]]
[[File:TEE mitral valve2.svg|thumb|left|300px]]
[[File:TG basal SAX.svg|thumb|left|300px]]
[[File:TG LAX.svg|thumb|left|300px]]
[[File:TG mid SAX.svg|thumb|left|300px]]
[[File:TG RV inflow-outflow.svg|thumb|left|300px]]
[[File:TG RV inflow.svg|thumb|left|300px]]
[[File:TG two-chamber.svg|thumb|left|300px]]
[[File:UE aortic arch LAX.svg|thumb|left|300px]]
[[File:UE aortic arch SAX.svg|thumb|left|300px]]

Latest revision as of 18:02, 13 October 2010

Continuity equation.svg
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Reference values for normal adult TEE measurements

Reference values for normal adult TEE measurements
Parameter   Mean ± SD (mm) Range (mm)
  Right pulmonary artery diametera 17 ± 3 12-22
Left upper pulmonary vein diameter 11 ± 2 7-16
Left atrial appendage Length 28 ± 5 15-43
Diameter 16 ± 5 10-28
Superior vena cava diameter 15 ± 3 8-20
Right ventricular outflow tract diameterb 27 ± 4 16-36
Left atriumc Anteroposterior diameter 38 ± 6 20-52
Medial-lateral diameter 39 ± 7 24-52
Right atriumc Anteroposterior diameter 38 ± 5 28-52
Medial-lateral diameter 38 ± 6 29-53
Tricuspid annular diameterc 28 ± 5 20-40
Mitral annular diameterc 29 ± 4 20-38
Coronary sinus diameter 6.6 ± 1.5 4-10
Left ventricled Anteroposterior diameter (diastole) 43 ± 7 33-55
Medial-lateral diameter (diastole) 42 ± 7 23-54
Anteroposterior diameter (systole) 28 ± 6 18-40
Medial-lateral diameter (systole) 27 ± 6 18-42
Aortic root diameterb 28 ± 3 21-34
Descending thoracic aorta diameter Proximal 21 ± 4 14-30
Distal 20 ± 4 13-28
  • aRight pulmonary artery diameter measured in midesophageal ascending aorta short-axis view.
  • bAortic root and right ventricular outflow tract diameters measured in the midesophageal right ventricular inflow/outflow tract view.
  • cAtrial (end-systole) and both mitral and tricuspid annular (mid-diastole) diameters measured in the midesophageal four-chamber view.
  • dLeft ventricular dimensions measured in transgastric mid short-axis view.
  • SD, standard deviation.
  • Adapted from Cohen G, White M, Sochowski R, et al. Reference values for normal transesophageal measurements. J Am Soc Echocardiogr 1995;8:221-230.


Normal Doppler echocardiographic values of aortic valve prosthesis

Normal Doppler echocardiographic values of aortic valve prosthesis
Valve Size n Peak gradient
(mm Hg) 		Mean gradient
(mm Hg) 		Peak velocity
(m/s) 		Effective orifice area
(cm2)
ATS open pivot AP ATS open pivot (bileaflet) 16 6 47.7 ± 12 27 ± 7.3 3.44 ± 0.47 0.61 ± 0.09
19 9 47 ± 12.6 26.2 ± 7.9 3.41 ± 0.43 0.96 ± 0.18
21 15 25.5 ± 6.1 14.4 ± 3.5 2.4 ± 0.39 1.58 ± 0.37
23 8 19 ± 7 12 ± 4   1.8 ± 0.2
25 12 17 ± 8 11 ± 4   2.2 ± 0.4
27 10 14 ± 4 9 ± 2   2.5 ± 0.3
29 5 11 ± 3 8 ± 2   3.1 ± 0.3
Biocor stentless (stentless bioprosthesis) 21 45 35.97 ± 4.06 18 ± 4    
23 115 29.15 ± 8.28 18.64 ± 7.14 3 ± 0.6 1.4 ± 0.5
25 100 28.65 ± 6.6 17.72 ± 6.99 2.8 ± 0.5 1.6 ± 0.38
27 55 25.87 ± 2.81 18 ± 2.8 2.7 ± 0.2 1.9 ± 0.46
≥29 16 24 ± 2      
Biocor extended stentless (stentless bioprosthesis) 19–21 12 17.5 ± 5.8 9.7 ± 3.5   1.3 ± 0.4
23 18 14.8 ± 5.9 8.1 ± 3.1   1.6 ± 0.3
25 20 14.2 ± 3.5 7.7 ± 1.9   1.8 ± 0.3
Bioflo pericardial (stented bioprosthesis) 19 16 37.25 ± 8.65 24.15 ± 5.1   0.77 ± 0.11
21 9 28.7 ± 6.2 18.7 ± 5.5   1.1 ± 0.1
23 4 20.7 ± 4 125 ± 3   1.3 ± 0.09
Björk-Shiley monostrut (tilting disk) 19 37 46.0 26.67 ± 7.87 3.3 ± 0.6 0.94 ± 0.19
21 161 32.41 ± 9.73 18.64 ± 6.09 2.9 ± 0.4  
23 153 26.52 ± 9.67 14.5 ± 6.2 2.7 ± 0.5  
25 89 22.33 ± 7 13.3 ± 4.96 2.5 ± 0.4  
27 61 18.31 ± 8 10.41 ± 4.38 2.1 ± 0.4  
29 9 12 ± 8 7.67 ± 4.36 1.9 ± 0.2  
Björk-Shiley spherical (tilting disk) or not specified 17 1     4.1  
19 2 27.0 21.8 ± 3.4 3.8 1.1
21 18 38.94 ± 11.93 17.34 ± 6.86 2.92 ± 0.88 1.1 ± 0.25
23 41 33.86 ± 11 11.5 ± 4.55 2.42 ± 0.4 1.22 ± 0.23
25 39 20.39 ± 7.07 10.67 ± 4.31 2.06 ± 0.28 1.8 ± 0.32
27 23 19.44 ± 7.99   1.77 ± 0.12 2.6
29 5 21.1 ± 7.1   1.87 ± 0.18 2.52 ± 0.69
31 2     2.1 ± 0.14  
Carbomedics (bileaflet) 17 7 33.4 ± 13.2 20.1 ± 7.1   1.02 ± 0.2
19 63 33.3 ± 11.19 11.61 ± 5.08 3.09 ± 0.38 1.25 ± 0.36
21 111 26.31 ± 10.25 12.68 ± 4.29 2.61 ± 0.51 1.42 ± 0.36
23 120 24.61 ± 6.93 11.33 ± 3.8 2.42 ± 0.37 1.69 ± 0.29
25 103 20.25 ± 8.69 9.34 ± 4.65 2.25 ± 0.34 2.04 ± 0.37
27 57 19.05 ± 7.04 8.41 ± 2.83 2.18 ± 0.36 2.55 ± 0.34
29 6 12.53 ± 4.69 5.8 ± 3.2 1.93 ± 0.25 2.63 ± 0.38
Carbomedics reduced (bileaflet) 19 10 43.4 ± 1.8 24.4 ± 1.2   1.22 ± 0.08
Carbomedics supraannular top hat (bileaflet) 19 4 29.04 ± 10.1 19.5 ± 2.12 1.8 1 ± 0.18
21 30 29.61 ± 8.93 16.59 ± 5.79 2.62 ± 0.35 1.18 ± 0.33
23 30 24.38 ± 7.53 13.29 ± 3.73 2.36 ± 0.55 1.37 ± 0.37
25 1 22.0 11.0 2.4  
Carpentier-Edwards (stented bioprosthesis) 19 56 43.48 ± 12.72 25.6 ± 8.02   0.85 ± 0.17
21 73 27.73 ± 7.6 17.25 ± 6.24 2.37 ± 0.54 1.48 ± 0.3
23 100 28.93 ± 7.49 15.92 ± 6.43 2.76 ± 0.4 1.69 ± 0.45
25 85 23.95 ± 7.05 12.76 ± 4.43 2.38 ± 0.47 1.94 ± 0.45
27 50 22.14 ± 8.24 12.33 ± 5.59 2.31 ± 0.39 2.25 ± 0.55
29 24 22.0 9.92 ± 2.9 2.44 ± 0.43 2.84 ± 0.51
31 4     2.41 ± 0.13  
Carpentier-Edwards pericardial (stented prosthesis) 19 14 32.13 ± 3.35 24.19 ± 8.6 2.83 ± 0.14 1.21 ± 0.31
21 34 25.69 ± 9.9 20.3 ± 9.08 2.59 ± 0.42 1.47 ± 0.36
23 20 21.72 ± 8.57 13.01 ± 5.27 2.29 ± 0.45 1.75 ± 0.28
25 5 16.46 ± 5.41 9.04 ± 2.27 2.02 ± 0.31  
27 1 19.2 5.6 1.6  
29 1 17.6 11.6 2.1  
Carpentier-Edwards supraannular AV (stented bioprosthesis) 19 15 34.1 ± 2.7   1.1 ± 0.09  
21 8 25 ± 8 14 ± 5   1.06 ± 0.16
CryoLife O'Brien stentless (stentless prothesis) 19 47   12 ± 4.8   1.25 ± 0.1
21 163   10.33 ± 2   1.57 ± 0.6
23 40   8.5   2.2
25 40   7.9   2.3
27 39   7.4   2.7
Duromedics (Tekna; bileaflet) 19 1     3.6  
21 3 19.08 ± 16 8.98 ± 5   1.3
23 12 19.87 ± 7 7 ± 2 2.64 ± 0.27  
25 18 21 ± 9 5 ± 2 2.34 ± 0.38  
27 15 22.5 ± 12 6 ± 3 1.88 ± 0.6  
29 1 13.0 3.4 2.1  
Edwards Prima stentless (stentless bioprosthesis) 19 7 30.9 ± 11.7 15.4 ± 7.4   1 ± 0.3
21 30 31.22 ± 17.35 16.36 ± 11.36   1.25 ± 0.29
23 62 23.39 ± 10.17 11.52 ± 5.26 2.8 ± 0.4 1.49 ± 0.46
25 97 19.74 ± 10.36 10.77 ± 9.32 2.7 ± 0.3 1.7 ± 0.55
27 46 15.9 ± 7.3 7.1 ± 3.7   2 ± 0.6
29 11 11.21 ± 8.6 5.03 ± 4.53   2.49 ± 0.52
Hancock I (stented bioprosthesis) 21 1     3.5  
23 14 19.09 ± 4.35 12.36 ± 3.82 2.94 ± 0.24  
25 26 17.61 ± 3.13 11 ± 2.85 2.36 ± 0.37  
27 20 18.11 ± 6.92 10 ± 3.46 2.4 ± 0.36  
29 2     2.23 ± 0.04  
31 1     2.0  
Hancock II (stented bioprosthesis) 21 39 20 ± 4 14.8 ± 4.1   1.23 ± 0.27
23 119 24.72 ± 5.73 16.64 ± 6.91   1.39 ± 0.23
25 114 20 ± 2 10.7 ± 3   1.47 ± 0.19
27 113 14 ± 3     1.55 ± 0.18
29 35 15 ± 3     1.6 ± 0.15
Ionescu-Shiley (stented bioprosthesis) 17 11 42.0 21.1 ± 3.21   0.86 ± 0.1
19 63 23.17 ± 6.58 20.44 ± 8.47 2.63 ± 0.32 1.15 ± 0.18
21 11 27.63 ± 8.34 15.1 ± 1.56 2.75 ± 0.25  
23 5 18.09 ± 6.49 9.9 ± 2.85 2.1 0.38  
25 1 18.0      
27 3 14.75 ± 2.17 8.97 ± 0.57 1.92 ± 0.14  
29 1 16.0 7.3 2.0  
Jyros bileaflet (bileaflet) 22 4 17.3 10.8   1.5
24 7 18.6 11.4   1.5
26 8 14.4 8.4   1.7
28 3 10.0 5.7   1.9
30 1 8.0 6.0   1.6
Lillehei-Kaster (tilting disk) 14 1     2.7  
16 2     3.43 ± 0.39  
18 2     2.85 ± 0.21  
20 1     1.7  
Medtronic Freestyle stentless (stentless bioprosthesis) 19 11   13.0    
21 85   7.99 ± 2.6   1.6 ± 0.32
23 141   7.24 ± 2.5   1.9 ± 0.5
25 164   5.35 ± 1.5   2.03 ± 0.41
27 105   4.72 ± 1.6   2.5 ± 0.47
Medtronic-Hall (tilting disk) 20 24 34.37 ± 13.06 17.08 ± 5.28 2.9 ± 0.4 1.21 ± 0.45
21 30 26.86 ± 10.54 14.1 ± 5.93 2.42 ± 0.36 1.08 ± 0.17
23 27 26.85 ± 8.85 13.5 ± 4.79 2.43 ± 0.59 1.36 ± 0.39
25 17 17.13 ± 7.04 9.53 ± 4.26 2.29 ± 0.5 1.9 ± 0.47
27 8 18.66 ± 9.71 8.66 ± 5.56 2.07 ± 0.53 1.9 ± 0.16
29 1     1.6  
Medtronic intact (stented bioprosthesis) 19 16 39.43 ± 15.4 23.71 ± 9.3 2.5  
21 55 33.9 ± 12.69 18.74 ± 8.03 2.73 ± 0.44 1.55 ± 0.39
23 110 31.27 ± 9.62 18.88 ± 6.17 2.74 ± 0.37 1.64 ± 0.37
25 41 27.34 ± 10.59 16.4 ± 6.05 2.6 ± 0.44 1.85 ± 0.25
27 16 25.27 ± 7.58 15 ± 3.94 2.51 ± 0.38 2.2 ± 0.17
29 5 31.0 15.6 ± 2.1 2.8 2.38 ± 0.54
Medtronic Mosaic, porcine (stented bioprosthesis) 21 51   12.43 ± 7.3   1.6 ± 0.7
23 121   12.47 ± 7.4   2.1 ± 0.8
25 71   10.08 ± 5.1   2.1 ± 1.6
27 30   9.0    
29 6   9.0    
Mitroflow (stented bioprosthesis) 19 4 18.7 ± 5.1 10.3 ± 3   1.13 ± 0.17
21 7 20.2 15.4 2.3  
23 5 14.04 ± 4.91 7.56 ± 3.38 1.85 ± 0.34  
25 2 17 ± 11.31 10.8 ± 6.51 2 ± 0.71  
27 3 13 ± 3 6.57 ± 1.7 1.8 ± 0.2  
O'Brien-Angell stentless (annular position; stentless bioprosthesis) 23     14.5 ± 7.77   1.15 ± 0.07
25 50   19 ± 12.72   1.12 ± 0.25
27     18 ± 12.72   1.55 ± 0.21
29     12 ± 7.07   2.05 ± 1.2
O'Brien-Angell stentless (supraannular position; stentless bioprosthesis) 23     9 ± 1.4   1.58 ± 0.58
25 50   7.5 ± 0.7   2.37 ± 0.18
27     8.5 ± 0.7   2.85 ± 0.87
29     7 ± 1.4   2.7 ± 0.42
Omnicarbon (tilting disk) 21 71 36.79 ± 12.59 19.4 ± 5.46 2.93 ± 0.47 1.25 ± 0.43
23 83 29.33 ± 9.67 17.98 ± 6.06 2.66 ± 0.44 1.49 ± 0.34
25 81 24.29 ± 7.71 13.51 ± 3.85 2.32 ± 0.38 1.94 ± 0.52
27 40 19.63 ± 4.34 12.06 ± 2.98 2.08 ± 0.35 2.11 ± 0.46
29 5 17.12 ± 1.53 10 ± 1.53 1.9 ± 0.06 2.27 ± 0.23
Omniscience (tilting disk) 19 2 47.5 ± 3.5 28 ± 1.4   0.81 ± 0.01
21 5 50.8 ± 2.8 28.2 ± 2.17   0.87 ± 0.13
23 8 39.8 ± 8.7 20.1 ± 5.1   0.98 ± 0.07
On-X (bileaflet) 19 6 21.3 ± 10.8 11.8 ± 3.4   1.5 ± 0.2
21 11 16.4 ± 5.9 9.9 ± 3.6   1.7 ± 0.4
23 23 15.9 ± 6.4 8.5 ± 3.3   2 ± 0.6
25 12 16.5 ± 10.2 9 ± 5.3   2.4 ± 0.8
27–29 8 11.4 ± 4.6 5.6 ± 2.7   3.2 ± 0.6
Sorin Allcarbon (tilting disk) 19 7 44 ± 7 29 ± 8 3.3 ± 0.3 0.9 ± 0.1
21 25 36.52 ± 9.61 21.07 ± 6.72 2.93 + 0.2 1.08 ± 0.19
23 37 34.97 ± 10.97 18.72 ± 6.49 2.9 ± 0.41 1.31 ± 0.2
25 23 22 ± 4.68 13.85 ± 3.97 2.37 ± 0.23 1.96 ± 0.71
27 13 16.3 ± 3.3 10.15 ± 3.76 2 ± 0.25 2.51 ± 0.57
29 4 13 ± 4 8 ± 2 1.8 ± 0.3 4.1 ± 0.7
Sorin Bicarbon (bileaflet) 19 19 29.53 ± 4.46 16.35 ± 1.99 2.5 ± 0.1 1.36 ± 0.13
21 70 24.52 ± 7.1 12.54 ± 3.3 2.46 ± 0.31 1.46 ± 0.2
23 71 17.79 ± 6.1 9.61 ± 3.3 2.11 ± 0.24 1.98 ± 0.23
25 40 18.46 ± 3.1 10.05 ± 1.6 2.25 ± 0.19 2.39 ± 0.29
27 8 12 ± 3.25 7 ± 1.5 1.73 ± 0.21 3.06 ± 0.47
29 4 9 ± 1.25 5 ± 0.5 1.51 ± 0.1 3.45 ± 0.02
Sorin Pericarbon (stentless bioprosthesis) 23 15 39 ± 13 25 ± 8   2.0
St. Jude Medical (bileaflet) 19 100 35.17 ± 11.16 18.96 ± 6.27 2.86 ± 0.48 1.01 ± 0.24
21 207 28.34 ± 9.94 15.82 ± 5.67 2.63 ± 0.48 1.33 ± 0.32
23 236 25.28 ± 7.89 13.77 ± 5.33 2.57 ± 0.44 1.6 ± 0.43
25 169 22.57 ± 7.68 12.65 ± 5.14 2.4 ± 0.45 1.93 ± 0.45
27 82 19.85 ± 7.55 11.18 ± 4.82 2.24 ± 0.42 2.35 ± 0.59
29 18 17.72 ± 6.42 9.86 ± 2.9 2 ± 0.1 2.81 ± 0.57
31 4 16.0 10 ± 6 2.1 ± 0.6 3.08 ± 1.09
St. Jude Medical Hemodynamic Plus (bileaflet) 19 19 25.81 ± 7.52 16.44 ± 3.57   1.65 ± 0.2
21 30 18.9 ± 7.31 9.62 ± 3.37   2.15 ± 0.29
Starr-Edwards (ball-and-cage) 21 5 29.0     1.0
22 2     4  
23 22 32.6 ± 12.79 21.98 ± 8.8 3.5 ± 0.5 1.1
24 43 34.13 ± 10.33 22.09 ± 7.54 3.35 ± 0.48  
26 29 31.83 ± 9.01 19.69 ± 6.05 3.18 ± 0.35  
27 14 30.82 ± 6.3 18.5 ± 3.7   1.8
29 8 29 ± 9.3 16.3 ± 5.5    
Stentless porcine xenograft (stentless bioprosthesis) 21 3 14 ± 5 8.7 ± 3.5   1.33 ± 0.38
22 3 16 ± 5.6 9.7 ± 3.7   1.32 ± 0.48
23 4 13 ± 4.8 7.7 ± 2.3   1.59 ± 0.6
24 3 13 ± 3.8 7.7 ± 2.2   1.4 ± 0.01
25 6 11.5 ± 7.1 7.4 ± 4.5   2.13 ± 0.7
26 3 10.7 7 ± 2.1   2.15 ± 0.2
27 1 9.2 5.5   3.2
28 1 7.5 4.1   2.3
Toronto stentless, porcine (stentless bioprosthesis) 20 1 10.9 4.6   1.3
21 9 18.64 ± 11.8 7.56 ± 4.4   1.21 ± 0.7
22 1 23.0     1.2
23 84 13.55 ± 7.28 7.08 ± 4.33   1.59 ± 0.84
25 190 12.17 ± 5.75 6.2 ± 3.05   1.62 ± 0.4
27 240 9.96 ± 4.56 4.8 ± 2.33   1.95 ± 0.42
29 200 7.91 ± 4.17 3.94 ± 2.15   2.37 ± 0.67

Normal Doppler echocardiographic values for mitral valve prosthesis

Normal Doppler echocardiographic values for mitral valve prosthesis
Valve Size n Peak gradient
(mm Hg) 		Mean gradient
(mm Hg) 		Peak velocity
(m/s) 		Pressure half-time
(ms) 		Effective orifice area
(cm2)
Biocor (stentless bioprosthesis) 27 3 13 ± 1        
29 3 14 ± 2.5        
31 8 11.5 ± 0.5        
33 9 12 ± 0.5        
Bioflo pericardial (stented bioprosthesis) 25 3 10 ± 2 6.3 ± 1.5     2 ± 0.1
27 3 9.5 ± 2.6 5.4 ± 1.2     2 ± 0.3
29 8 5 ± 2.8 3.6 ± 1     2.4 ± 0.2
31 1 4.0 2.0     2.3
Björk-Shiley (tilting disk) 23 1     1.7 115  
25 14 12 ± 4 6 ± 2 1.75 ± 0.38 99 ± 27 1.72 ± 0.6
27 34 10 ± 4 5 ± 2 1.6 ± 0.49 89 ± 28 1.81 ± 0.54
29 21 7.83 ± 2.93 2.83 ± 1.27 1.37 ± 0.25 79 ± 17 2.1 ± 0.43
31 21 6 ± 3 2 ± 1.9 1.41 ± 0.26 70 ± 14 2.2 ± 0.3
Björk-Shiley monostrut (tilting disk) 23 1   5.0 1.9    
25 102 13 ± 2.5 5.57 ± 2.3 1.8 ± 0.3    
27 83 12 ± 2.5 4.53 ± 2.2 1.7 ± 0.4    
29 26 13 ± 3 4.26 ± 1.6 1.6 ± 0.3    
31 25 14 ± 4.5 4.9 ± 1.6 1.7 ± 0.3    
Carbomedics (bileaflet) 23 2     1.9 ± 0.1 126 ± 7  
25 12 10.3 ± 2.3 3.6 ± 0.6 1.3 ± 0.1 93 ± 8 2.9 + 0.8
27 78 8.79 ± 3.46 3.46 ± 1.03 1.61 ± 0.3 89 ± 20 2.9 + 0.75
29 46 8.78 ± 2.9 3.39 ± 0.97 1.52 ± 0.3 88 ± 17 2.3 + 0.4
31 57 8.87 ± 2.34 3.32 ± 0.87 1.01 ± 0.29 92 ± 24 2.8 + 1.14
33 33 8.8 ± 2.2 4.8 ± 2.5 1.5 ± 0.2 93 ± 12  
Carpentier-Edwards (stented bioprosthesis) 27 16   6 ± 2 1.7 ± 0.3 98 ± 28  
29 22   4.7 ± 2 1.76 ± 0.27 92 ± 14  
31 22   4.4 ± 2 1.54 ± 0.15 92 ± 19  
33 6   6 ± 3   93 ± 12  
Carpentier-Edwards pericardial(stented bioprosthesis) 27 1   3.6 1.6 100  
29 6   5.25 ± 2.36 1.67 ± 0.3 110 ± 15  
31 4   4.05 ± 0.83 1.53 ± 0.1 90 ± 11  
33 1   1.0 0.8 80  
Duromedics (bileaflet) 27 8 13 ± 6 5 ± 3   75 ± 12  
29 14 10 ± 4 3 ± 1 161 ± 40 85 ± 22  
31 21 10.5 ± 4.37 3.3 ± 1.36 140 ± 25 81 ± 12  
33 1 11.2 2.5 138 ± 27 85  
Hancock I or not specified (stented bioprosthesis) 27 3 10 ± 4 5 ± 2     1.3 ± 0.8
29 13 7 ± 3 2.46 ± 0.79   115 ± 20 1.5 ± 0.2
31 22 4 ± 086 4.86 ± 1.69   95 ± 17 1.6 ± 0.2
33 8 3 ± 2 3.87 ± 2   90 ± 12 1.9 ± 0.2
Hancock II (stented bioprosthesis) 27 16         2.21 ± 0.14
29 64         2.77 ± 0.11
31 90         2.84 ± 0.1
33 25         3.15 ± 0.22
Hancock pericardial (stented bioprosthesis) 29 14   2.61 ± 1.39 1.42 ± 0.14 105 ± 36  
31 8   3.57 ± 1.02 1.51 ± 0.27 81 ± 23  
Ionescu-Shiley (stented bioprosthesis) 25 3   4.87 ± 1.08 1.43 ± 0.15 93 ± 11  
27 4   3.21 ± 0.82 1.31 ± 0.24 100 ± 28  
29 6   3.22 ± 0.57 1.38 ± 0.2 85 ± 8  
31 4   3.63 ± 0.9 1.45 ± 0.06 100 ± 36  
Ionescu-Shiley low profile (stented bioprosthesis) 29 13   3.31 ± 0.96 1.36 ± 0.25 80 ± 30  
31 10   2.74 ± 0.37 1.33 ± 0.14 79 ± 15  
Labcor-Santiago pericardial (stented bioprosthesis) 25 1 8.7 4.5   97 2.2
27 16 5.6 ± 2.3 2.8 ± 1.5   85 ± 18 2.12 ± 0.48
29 20 6.2 ± 2.1 3 ± 1.3   80 ± 34 2.11 ± 0.73
Lillehei-Kaster (tilting disk) 18 1     1.7 140  
20 1     1.7 67  
22 4     1.56 ± 0.09 94 ± 22  
25 5     1.38 ± 0.27 124 ± 46  
Medtronic-Hall (tilting disk) 27 1     1.4 78  
29 5     1.57 ± 0.1 69 ± 15  
31 7     1.45 ± 0.12 77 ± 17  
Medtronic Intact, porcine (stented prosthesis) 29 3   3.5 ± 0.51 1.6 ± 0.22    
31 14   4.2 ± 1.44 1.6 ± 0.26    
33 13   4 ± 1.3 1.4 ± 0.24    
35 2   3.2 ± 1.77 1.3 ± 0.5    
Mitroflow (stented bioprosthesis) 25 1   6.9 2.0 90  
27 3   3.07 ± 0.91 1.5 90 ± 20  
29 15   3.5 ± 1.65 1.43 ± 0.29 102 ± 21  
31 5   3.85 ± 0.81 1.32 ± 0.26 91 ± 22  
Omnicarbon (tilting disk) 23 1   8.0      
25 16   6.05 ± 1.81 1.77 ± 0.24 102 ± 16  
27 29   4.89 ± 2.05 1.63 ± 0.36 105 ± 33  
29 34   4.93 ± 2.16 1.56 ± 0.27 120 ± 40  
31 58   4.18 ± 1.4 1.3 ± 0.23 134 ± 31  
33 2   4 ± 2      
On-X (bileaflet) 25 3 11.5 ± 3.2 5.3 ± 2.1     1.9 ± 1.1
27–29 16 10.3 ± 4.5 4.5 ± 1.6     2.2 ± 0.5
31–33 14 9.8 ± 3.8 4.8 ± 2.4     2.5 ± 1.1
Sorin Allcarbon (tilting disk) 25 8 15 ± 3 5 ± 1 2 ± 0.2 105 ± 29 2.2 ± 0.6
27 20 13 ± 2 4 ± 1 1.8 ± 0.1 89 ± 14 2.5 ± 0.5
29 34 10 ± 2 4 ± 1 1.6 ± 0.2 85 ± 23 2.8 ± 0.7
31 11 9 ± 1 4 ± 1 1.6 ± 0.1 88 ± 27 2.8 ± 0.9
Sorin Bicarbon (bileaflet) 25 3 15 ± 0.25 4 ± 0.5 1.95 ± 0.02 70 ± 1  
27 25 11 ± 2.75 4 ± 0.5 1.65 ± 0.21 82 ± 20  
29 30 12 ± 3 4 ± 1.25 1.73 ± 0.22 80 ± 14  
31 9 10 ± 1.5 4 ± 1 1.66 ± 0.11 83 ± 14  
St. Jude Medical (bileaflet) 23 1   4.0 1.5 160 1.0
25 4   2.5 ± 1 1.34 ± 1.12 75 ± 4 1.35 ± 0.17
27 16 11 ± 4 5 ± 1.82 1.61 ± 0.29 75 ± 10 1.67 ± 0.17
29 40 10 ± 3 4.15 ± 1.8 1.57 ± 0.29 85 ± 10 1.75 ± 0.24
31 41 12 ± 6 4.46 ± 2.22 1.59 ± 0.33 74 ± 13 2.03 ± 0.32
Starr-Edwards (ball-and-cage) 26 1   10.0     1.4
28 27   7 ± 2.75     1.9 ± 0.57
30 25 12.2 ± 4.6 6.99 ± 2.5 1.7 ± 0.3 125 ± 25 1.65 ± 0.4
32 17 11.5 ± 4.2 5.08 ± 2.5 1.7 ± 0.3 110 ± 25 1.95 ± 0.4
34 1   5.0     2.6
Stentless quadrileaflet bovine pericardial (stentless bioprosthesis) 26 2   2.2 ± 1.7 1.6 103 ± 31 1.7
28 14     1.58 ± 0.25   1.7 ± 0.6
30 6     1.42 ± 0.32   2.3 ± 0.4
Wessex (stented bioprosthesis) 29 9   3.69 ± 0.61 1.66 ± 0.17 83 ± 19  
31 22   3.31 ± 0.83 1.41 ± 0.25 80 ± 21  

Transesophageal Echocardiographic Anatomy

Transesophageal Echocardiographic Anatomy
ME two-chamber Probe adjustment: neutral Sector depth: ~14 cm
image 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
image Primary diagnostic issues
  • Mitral valve pathology
  • LVOT pathology
 Required structures
  • LV
  • Mitral valve
  • LVOT
ME mitral commissural Probe adjustment: neutral Sector depth: ~12 cm
image 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
image 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
image 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
image 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
image 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
image 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
image 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
image 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.
  • Modified from Miller JP, Lambert SA, Shapiro WA, et al. The adequacy of basic intraoperative transesophageal echocardiography performed by experienced anesthesiologist. Anesth Analg 2001;92:1103–1110, with permission.
Deep TG LAX.svg
Desc aortic LAX.svg
Desc aortic SAX.svg
ME asc aortic LAX.svg
ME asc aortic SAX.svg
ME AV LAX.svg
ME AV SAX.svg
ME bicaval.svg
ME four chamber.svg
ME LAX.svg
ME mitral commissural.svg
ME RV inflow-outflow.svg
ME two-chamber.svg
TEE coronary region.svg
TEE LV Sections.svg
TEE mitral valve.svg
TEE mitral valve2.svg
TG basal SAX.svg
TG LAX.svg
TG mid SAX.svg
TG RV inflow-outflow.svg
TG RV inflow.svg
TG two-chamber.svg
UE aortic arch LAX.svg
UE aortic arch SAX.svg
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