Structure Specific Views for TEE

Click the videos below which will have addition comments description section on these views. 

Left Atrial Appendage 

To get the appendage in view you will need to withdrawn the probe a little from the mid esophageal 4 chamber view and put a decent amount of antiflexion on the problem. As you omniplane up you will need to add some counterclockwise rotation.

Left Sided Pulmonary Veins
 

Both left sided pulmonary veins can be seen at the same time at higher angles around 110 with a lot of counterclockwise rotation past where the Left atrial appendage is seen. Sometimes a higher angle and more insertion is need to see the left lower vein. In other angles 60 degrees the left upper vein is seen just to the right of the appendange 

Left Pulm Veins.jpg
PW LUPV.jpg

PW of the left upper pulmonary vein

PW LLPV.jpg

PW of the left lower pulmonary vein

Right  Sided Pulmonary Veins
 

Right Pulm Veins 2.jpg

Both right sided veins are best seen in the 60 to 90 degree view with a lot of clockwise rotation from the position of the bicaval view. At the bicaval view with initial counter clockwise rotation the right upper vein is seen but with additional rotation and lowering of the angle as well as some insertion the lower can also be seen (on the right of the screen. Some individuals also have an additional right or left pulmonary vein as show in the example below.

PW RUPV.jpg

PW of the right upper pulmonary vein

PW RLPV.jpg

PW of the right lower pulmonary vein

Right Pulm Veins.jpg

Example of 3 right sided pulmonary veins