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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.