Anesthesiology & Pain Medicine >> Education >> TEE of the Month

Transesophageal Echocardiogram of the Month

TEE pictures furnished by Dr. Donald Oxorn, UW Anesthesiologist

You might also like to visit the Canadian Society of Echocardiography-Cardiomath Echo Calculator

For those with smartphones or iPads I recommend the following apps as excellent reference guides. The first is from the University of Toronto (same folks who brought you the Virtual TEE website) and the next 3 are from the American Society of Echocardiography


TEE Standard Views on Apple iPad App icon

iTunes Preview

Echo AUC App icon

American Society of Echocardiography
Echo AUC

iTunes Preview

ASA Pocket Guidelines App icon

American Society of Echocardiography
ASE Pocket Guidelines

iTunes Preview

iASE App icon

American Society of Echocardiography
iASE

iTunes Preview


Now available:

coming later in 2016

(click image to enlarge)

Book purchase allows the individual to utilize the Inkling platform on tablets and smart-phones to view full text and videos.




March 2017

March question: This 70 year old male presented with fevers, rigors and shortness of breath of 3 weeks duration. Judging by what you seen in the first 2 videos, what is the significance of the findings in video 3 and image 1?

Image 1 - TEE of the Month
Image'1'   (click to enlarge)

Video 1 - TEE of the Month
Video'1'   (click to enlarge)


Video 2 - TEE of the Month
Video'2'   (click to enlarge)

Video 3 - TEE of the Month
Video'3'   (click to enlarge)


Submit Your Answer Here


February 2017

February question: This patient was being worked up for hemolysis. TEE is shown. What is the problem and where is it located? Any other investigations warranted?

Video 1 - TEE of the Month
Video'1'   (click to enlarge)

Video 2 - TEE of the Month
Video'2'   (click to enlarge)


February answer: In February answer 1, the white arrow indicates the perivalvular jet which in this long axis view is posterior. In February answer 2, multiplanar reconstruction of the jet allows measurement of the defect size (black arrow). The white arrow indicates intravalvular regurgitation. In January answer 3, an occluder has been placed postero-medially.

Video 1 - TEE of the Month
Image '1'   (click to enlarge)


Video 2 - TEE of the Month
Image '2'   (click to enlarge)

Video 1 - TEE of the Month
Image '3'   (click to enlarge)





January 2017

January question: What congenital abnormality is seen in this patient? What is the significance of what the arrow in the spectral Doppler is pointing to? The second video is a cardiac MRI resembling a trans-gastric short axis.

Video 1 - TEE of the Month
Image'1'   (click to enlarge)

Video 1 - TEE of the Month
Video'1'   (click to enlarge)

Video 2 - TEE of the Month
Video'2'   (click to enlarge)


January answer:This patient had a double chamber right ventricle-essentially 2RV “chambers” separated by a muscular narrowing in the RVOT
History: angina, dyspnea, dizziness, syncope
PE: harsh systolic ejection murmur at left sternal border
EKG: right ventricular hypertrophy
Diagnosis: TTE, TEE and cardiac MRI.

Associated Abnormalities

VSD (~ 75%)
Valvular pulmonary stenosis
Tetrology of Fallot
Double-outlet RV
Subaortic obstruction
Persistent left SVC

Surgery

  • Indications
  • Symptomatic patient
    Peak gradient > 50 mmHg
  • Usually repaired in childhood or adolescence
  • Approach
  • Right transatrial
    Right transatrial-pulmonary
    Right ventriculotomy

Our patient’s operative procedure: Resection of right ventricular outflow muscle and enlargement, reconstruction of the distal main pulmonary artery, the anterior one third of the pulmonic valve annulus, and the right ventricular outflow tract with CorMatrix oval patch. The postoperative gradient was small. (Images and discussion courtesy of Peter Von Homeyer an Srdjan Jelacic.) In the postoperative video, the small jet at the inter-ventricular septum was thought to be an anomalous coronary artery.


Answer Image - TEE of the Month
Answer Image'1'   (click to enlarge)

Answer Video - TEE of the Month
Answer Video'1'   (click to enlarge)