TEE views

Question 1

Answer 1

Mid-Esophageal 4 chamber view. Structures: R atrium, R ventricle, L atrium, L ventricle, anterior and posterior mitral leaflets. 30-35 cm into the esophagus. Turn R until you center on mitral valve. Plane to 10-20 degrees.

Question 2

Answer 2

Mid-Esophageal 2 chamber view. Multiplane to between 80-100 degrees.
Structures: LA, LV, coronary sinus, L atrial appendage

Question 3

Answer 3

Mid-Esophageal Long Axis View. Multiplane to between 120-140 degrees. Center LVOT. Structures: L atrium, L ventricle, LVOT, aortic valve, R ventricle, posterior & anterior leaflets of mitral valve.

Question 4

Answer 4

Mid-Esophageal Ascending Aorta Long Axis
Withdraw slightly from MELAX to see the aorta.
Structures: Aorta and R pulmonary artery. Rotate counterclockwise to see pulmonic valve.

Question 5

Answer 5

Mid-Esophageal Ascending Aorta Short Axis view - Aorta, superior vena cava, right pulmonary artery, main pulmonary artery. You find main PA on MEAscAoSAX and then multiplane to 20-40 degrees. Can sometimes see PE, good for pulmonic valve pathology as well.

Question 6

Answer 6

Mid-Esophageal Aortic Valve Short Axis View - LA, RA, RV, tricuspid valve, pulmonic valve, aortic valve. Advance probe from MEAscAoSAX until you can see it.

Question 7

Answer 7

Mid-Esophageal RV Inflow-Outflow View - AV, RA, RV, tricuspid valve, pulmonic valve. Advance probe slightly from MEAVSAX and then rotate probe clockwise to center tricuspid valve. Multiplane to between 60-90 degrees. Good for TV pathology, PV pathology, and right heart function.

Question 8

Answer 8

Mid-Esophageal Bicaval view
- RA, LA, IVC, SVC - Start with ME RV inflow/outflow and multiplane to 90-110 degrees, rotate probe clockwise. Good for looking for thrombus in the IVC/SVC, looking for appropriate pacing wire placement in RA.

Question 9

Answer 9

Trans-gastric mid-papillary short axis view - start at ME 4CH view at 0 on the multiplane, advance probe to stomach and then anteflex. Manipulate probe depth until you can see posteromedial and anterolateral papillary muscles. See right and left ventricles. Good for regional wall movement abnormalities. Good for volume assessment.

Question 10

Answer 10

Descending Aortic Short Axis - Start at ME4Ch, rotate counterclockwise until you can see the aorta. Good for descending aortic pathology and balloon pump placement.

Question 11

Answer 11

Descending Aortic Long Axis View - flip multiplane to 90 degrees from Descending Aortic SAX view. Also good for visualizing descending aorta pathology.