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Normal Values of TEE: Difference between revisions
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<!-- TABLE 3 --> | <!-- TABLE 3 --> | ||
==Transesophageal Echocardiographic Anatomy== | |||
{| class="wikitable" style="font-size:90%;" | |||
|+'''Transesophageal Echocardiographic Anatomy''' | |||
! ME two-chamber | |||
| Probe adjustment: neutral | |||
| Sector depth: ~14 cm | |||
|- | |||
| image | |||
| valign="top" | Primary diagnostic issues | |||
<ul> | |||
<li>LA appendage</li> | |||
<li>Mass/thrombus</li> | |||
<li>LV apex pathology</li> | |||
<li>LV systolic dysfunction (apical segments)</li> | |||
</ul> | |||
| valign="top" | Required structures | |||
<ul> | |||
<li>LA appendage</li> | |||
<li>Mitral valve</li> | |||
<li>LV apex (i.e., maximal LV length)</li> | |||
</ul> | |||
|- | |||
! ME LAX | |||
| Probe adjustment: neutral | |||
| Sector depth: ~12 cm | |||
|- | |||
| image | |||
| valign="top" | Primary diagnostic issues | |||
<ul> | |||
<li>Mitral valve pathology</li> | |||
<li>LVOT pathology</li> | |||
</ul> | |||
| valign="top" | Required structures | |||
<ul> | |||
<li>LV</li> | |||
<li>Mitral valve</li> | |||
<li>LVOT</li> | |||
</ul> | |||
|- | |||
! ME mitral commissural | |||
| Probe adjustment: neutral | |||
| Sector depth: ~12 cm | |||
|- | |||
| image | |||
| valign="top" | Primary diagnostic issues | |||
<ul> | |||
<li>Localization of mitral valve pathology</li> | |||
</ul> | |||
| valign="top" | Required structures | |||
<ul> | |||
<li>Mitral valve (P<sub>1</sub>, P<sub>3</sub> and A<sub>2</sub> scallops)</li> | |||
<li>Papillary muscles/chordae tendineae</li> | |||
<li>LA</li> | |||
<li>LV</li> | |||
</ul> | |||
|- | |||
! TG mid-SAX | |||
| Probe adjustment: neutral | |||
| Sector depth: ~12 cm | |||
|- | |||
| image | |||
| valign="top" | Primary diagnostic issues | |||
<ul> | |||
<li>Hemodynamic instability</li> | |||
<li>LV enlargement</li> | |||
<li>LV hypertrophy</li> | |||
<li>LV systolic dysfunction (global and regional)</li> | |||
</ul> | |||
| valign="top" | Required structures | |||
<ul> | |||
<li>LV cavity</li> | |||
<li>LV walls (at least 50% of circumference with visible endocardium)</li> | |||
<li>Papillary muscles (approximately equal in size and distinct from ventricular wall)</li> | |||
</ul> | |||
|- | |||
! TG two-chamber | |||
| Probe adjustment: neutral | |||
| Sector depth: ~12 cm | |||
|- | |||
| image | |||
| valign="top" | Primary diagnostic issues | |||
<ul> | |||
<li>LV systolic dysfunction (anterior and inferior basal segments)</li> | |||
</ul> | |||
| valign="top" | Required structures | |||
<ul> | |||
<li>Mitral leaflets</li> | |||
<li>Mitral subvalvular apparatus</li> | |||
<li>LV (anterior and inferior: basal plus mild segments)</li> | |||
</ul> | |||
|- | |||
! TG RV inflow | |||
| Probe adjustment: neutral-rightward | |||
| Sector depth: ~12 cm | |||
|- | |||
| image | |||
| valign="top" | Primary diagnostic issues | |||
<ul> | |||
<li>RV systolic dysfunction</li> | |||
<li>Tricuspid valve pathology</li> | |||
</ul> | |||
| valign="top" | Required structures | |||
<ul> | |||
<li>Tricuspid leaflets</li> | |||
<li>Tricuspid subvalvular apparatus</li> | |||
</ul> | |||
|- | |||
! 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;92:1103–1110, with permission.</li> | |||
</ul> | |||
|} | |||
==Positions of measurements== | ==Positions of measurements== | ||
<gallery> | <gallery> | ||