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


July 2014

July Question: What is the rare abnormality seen in the video and image (images courtesy of Burkhard Mackensen)?


Image 1 - July 2014 - Tee of the Month
Image '1'   (click to enlarge)

Video 1 - July 2014 - Tee of the Month
Video '1'   (click to enlarge)


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June 2014

June Question: What is the structure indicated by the question marks?


Video 1 - June 2014 - Tee of the Month
Video '1'   (click to enlarge)

Video 2 - June 2014 - Tee of the Month
Video '2'   (click to enlarge)


Image 1 - June 2014 - Tee of the Month
Image '1'   (click to enlarge)

June Answer: The structure in question is a pseudoaneurysm of the mitral aortic intervalvular fibrosa, an area which is especially prone to complications following aortic valve endocarditis. In the current case, the patient had a previous tissue aortic valve replacement. It is likely that he subsequently developed endocarditis with pseudoaneurysm formation posterior to the aortic root. Color flow Doppler establishes to and fro movement form the LVOT to the pseudoaneurysm, and the absence of any communication with the left atrium. The asterix indicates the orifice of the pseudoaneurysm in the 3D image:

Answer Image 1 - June 2014 - Tee of the Month
Answer Image '1'   (click to enlarge)


May 2014

May Question:  Your colleague calls you to help define an image- an object seen above the right coronary cusp. (Videos 1 & 2, Images 1 & 2 arrows); however when he images the aortic valve while imaging the mitral valve, the object is not there (Video 3). Returning to the original window, the object returns. What do you do to further define this object? What is your suspicion?


Video 1 - May 2014 - Tee of the Month
Video '1'   (click to enlarge)

Video 2 - May 2014 - Tee of the Month
Video '2'   (click to enlarge)


Video 3 - May 2014 - Tee of the Month
Video '3'   (click to enlarge)

Video 4 - May 2014 - Tee of the Month
Video '4'   (click to enlarge)

Image 1 - May 2014 - Tee of the Month
Image '1'   (click to enlarge)

Image 2 - May 2014 - Tee of the Month
Image '2'   (click to enlarge)

May Answer: This is an artifact. As seen in the first still, the arrow points to the artifact in 2D, and the M-mode shows fairly predictable motion. In the second still, the green arrow is the left atrial-aorta interface, and the red arrow is the reflection artifact. 3D artifacts have some unique features such as "blooming", seen here and often seen with prosthetic valves. See reference JASE 2014; 27:453-62.

Answer Image 1- May 2014 - Tee of the Month
Answer Image '1'   (click to enlarge)

Answer Image 2- May 2014 - Tee of the Month
Answer Image '2'   (click to enlarge)