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Book Details
Abstract
Now updated throughout, with new TEE views, new ASE guidelines, and new coverage of key topics, the TEE Pocket Manual, 2nd Edition, is an indispensable guide to transesophageal echocardiography and its clinical applications. This concise, complete handbook includes everything you need to know when doing TEE and for reporting: normal values, explanations of abnormal findings, schematics and tables, formulas, calculations, pitfalls and artifacts, and more.
- More TEE views – 28 in all – and additional line drawings.
- Updated grading for vascular disease based on ASE Guidelines, specifically aortic stenosis, aortic insufficiency, and mitral stenosis.
- Increased coverage of assessment of right ventral function, including dP/dt, volume overload, and pressure overload.
- Addition of the various transcatheter aortic valves to discussion of prosthetic valves.
- Expanded chapter on 3D TEE to include assessment of left ventricular function and mitral valve anatomy.
- New material on TEE for catheter-based interventions such as transcather aortic valve replacement, left atrial appendage occlusion and MitraClip.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| TEE Pocket Manual | iii | ||
| Copyright | iv | ||
| Preface | v | ||
| Acknowledgments | vii | ||
| Contents | ix | ||
| Glossary of Acronyms | x | ||
| Figure of TEE images | xiv | ||
| Basic Physics of Ultrasound | 1 | ||
| Physics | 1 | ||
| Ultrasound Principles and Characteristics (Figure 1.1) | 1 | ||
| Wavelength and Image Quality (Figure 1.2) | 2 | ||
| Transducer Frequencies | 3 | ||
| Ultrasound Interaction with Tissue | 3 | ||
| Transducer (Figures 1.3 and 1.4) | 4 | ||
| Imaging Options | 7 | ||
| Types of Doppler | 8 | ||
| Electrical Processing: Controls Used to Modify the Appearance of the Image | 10 | ||
| Three-Dimensional (3D) Imaging (also see Chapter 21 on 3D) | 11 | ||
| Systolic Left Ventricular (LV) Structure/Function | 13 | ||
| Assess LV Structure | 13 | ||
| Assess global function | 13 | ||
| Qualitative Evaluation | 13 | ||
| Quantitative Evaluation | 14 | ||
| Fractional Area Change (FAC) | 14 | ||
| M-mode: TG SAX or TG 2-chamber views. | 15 | ||
| 2D: ME Four-Chamber and ME Two-Chamber views | 16 | ||
| 3D: Using 3D Gated LV Imaging | 16 | ||
| Doppler: TG LAX (120°) or Deep TG 5-chamber | 16 | ||
| Assess Regional LV Function | 20 | ||
| Segmental Anatomy and Coronary Distribution | 21 | ||
| Diastolic Function | 23 | ||
| PWD Transmitral (Figure 3.1) | 23 | ||
| Distinguish Normal from Pseudonormal (Figure 3.8) | 28 | ||
| Pulmonary venous pressure Doppler gradient between pulmonary vein (PV) and LA | 29 | ||
| Normal PV Pattern of Diastolic Function (Figure 3.10) | 30 | ||
| PV Patterns of Diastolic Dysfunction (Figure 3.11) | 31 | ||
| TDI | 32 | ||
| Tissue Doppler Patterns of Diastolic Dysfunction (Figures 3.14-3.16) | 34 | ||
| Propagation Velocity: Color M-mode across MV in ME 4 in ME 4-Chamber View (Figure 3.17) | 35 | ||
| Diastolic Dysfunction Caveats | 35 | ||
| Right Ventricular Diastolic Function | 38 | ||
| Aortic Valve Anatomy | 39 | ||
| Normal anatomy | 39 | ||
| Normal values | 39 | ||
| Views to evaluate structures and function | 39 | ||
| Aortic Valve Stenosis | 43 | ||
| Assessing severity | 43 | ||
| Visual Appearance Using 2D (ME AV SAX; ME AV LAX) | 43 | ||
| Other Imaging Modalities (M-mode and CFD) | 43 | ||
| Transvalvular Gradients Using CWD (deep transgastric [DTG] 5-chamber; TG LAX between 90° and 120°) | 43 | ||
| Valve Area | 44 | ||
| Steps to Obtain AVA by Continuity Method (Figure 5.1) | 45 | ||
| LVOT Obstruction Differential | 48 | ||
| Obstructive Hypertrophic Cardiomyopathy (HCOM) Echocardigraphic Features | 49 | ||
| Measurements for AV Replacement | 49 | ||
| Aortic regurgitation | 51 | ||
| Etiology | 51 | ||
| Assess severity | 51 | ||
| 2D | 51 | ||
| CFD | 51 | ||
| CWD | 53 | ||
| AV Repair/Replacement | 53 | ||
| Mitral Valve Anatomy | 55 | ||
| Normal anatomy | 55 | ||
| Mitral Valve Stenosis | 57 | ||
| Pathologic features | 57 | ||
| Etiology | 57 | ||
| Qualitative evaluation | 57 | ||
| 2D: Best Views and Clues of Mitral Stenosis (MS) | 57 | ||
| CFD | 58 | ||
| CWD-Transmitral | 58 | ||
| Quantitate severity of mitral stenosis | 59 | ||
| Severe MS: Mean Gradient >10mm Hg | 59 | ||
| Measure MVA by Pressure Half-Time (PHT) | 59 | ||
| Severe MS: PHT ≥220 msec (MVA <1 cm2) | 60 | ||
| Severe MS: DT >∼ 750 msec | 61 | ||
| MV by Continuity Equation | 61 | ||
| PISA | 62 | ||
| Planimetry | 63 | ||
| Mitral Valve Regurgitation | 65 | ||
| Qualitative examination: evaluate mechanism of MR | 65 | ||
| 2D ME 4 Chamber (0°, 60°, 90°, 120°) | 65 | ||
| Types and source of MV leaflet motion | 65 | ||
| Identify the affected segment(S) | 67 | ||
| Semiquantitative exam: evaluate severity | 68 | ||
| CFD Spatial Area Mapping (Planimetry of Jet) | 68 | ||
| Proximal Isovolumic Surface Area (PISA) | 69 | ||
| PWD | 71 | ||
| Quantitative | 72 | ||
| Standard diagnostic examination for mitral regurgitation (Pre-cardiopulmonary bypass [CPB]) | 73 | ||
| Unique intraoperative examination (Post-MV repair) | 75 | ||
| Pulmonic Valve | 77 | ||
| Normal structure | 77 | ||
| Three Leaflets: Anterior, Left, and Right Views (Figures 10.1, 10.2, and 10.3) | 77 | ||
| Pulmonic Stenosis | 78 | ||
| Etiology (almost always congenital) | 78 | ||
| 2D | 78 | ||
| CWD | 79 | ||
| Pulmonic Regurgitation | 79 | ||
| Etiology | 79 | ||
| 2D | 80 | ||
| CFD | 80 | ||
| CWD | 80 | ||
| Tricuspid valve | 83 | ||
| Normal anatomy | 83 | ||
| Views | 84 | ||
| Views and pertinent tricuspid valve (TV) structure/function | 84 | ||
| ME 4-Chamber (Figure 11.2) | 84 | ||
| ME RV Inflow-Outflow (50°–75°) (Figure 11.3) | 85 | ||
| ME Modified Bicaval (50°–75°) (Figure 11.4) | 85 | ||
| TG Basal SAX | 86 | ||
| TG RV Inflow-Outflow (90°-110°) (Figure 11.5) | 86 | ||
| TG RV Inflow (90°-110°, rotate probe clockwise) (Figure 11.6) | 87 | ||
| Modified DTG View (Figure 11.7) | 87 | ||
| Triscuspid Regurgitation | 88 | ||
| Etiology | 88 | ||
| TR Evaluation | 88 | ||
| PWD: Hepatic Vein Flow (Figure 11.8A-C) | 89 | ||
| PWD: Tricuspid Inflow | 90 | ||
| CWD: TR | 91 | ||
| CFD | 91 | ||
| Vena Contracta (VC) | 91 | ||
| Pulmonary Artery Pressure (PAP) Evaluation by TR Jet (Figure 11.9) | 92 | ||
| TV Stenosis | 93 | ||
| Etiology | 93 | ||
| TS Evaluation | 93 | ||
| Severe TR | 94 | ||
| Right Ventricle | 95 | ||
| Useful tee views | 95 | ||
| Normal Anatomy | 96 | ||
| RV Dilation | 96 | ||
| RVH | 96 | ||
| RV Systolic Function | 97 | ||
| RV Wall Motion | 97 | ||
| Interventricular (IV) Septum Wall Motion | 97 | ||
| RV Failure | 98 | ||
| Prosthetic Valve Types | 99 | ||
| Mechanical valves | 99 | ||
| Ball-Cage (Starr-Edwards) (Figure 13.1) | 99 | ||
| Tilting Disk (Medtronic Hall and Bjork Shiley) (Figure 13.2) | 100 | ||
| Bileaflet (most commonly placed mechanical valves) | 101 | ||
| Biological valves | 103 | ||
| Heterografts (porcine or bovine) | 103 | ||
| Homografts (human) | 104 | ||
| Transcatheter AVs | 106 | ||
| Prosthetic valve dysfunction | 108 | ||
| Mechanical and Biological | 108 | ||
| TEE Examination of prosthetic valve post CPB | 109 | ||
| Endocarditis | 111 | ||
| Goals of TEE | 111 | ||
| M-Mode | 111 | ||
| 2D | 111 | ||
| Differential diagnosis | 112 | ||
| Associated Findings/Complications Shown by Echocardiography | 112 | ||
| Prognosis and Predicting Complication Risk with TEE | 115 | ||
| Pericardial Disease | 117 | ||
| Pericardial Effusion | 117 | ||
| Grading of Pericardial Effusion | 118 | ||
| Pericardial versus Pleural Effusion | 118 | ||
| Cardiac tamponade | 119 | ||
| Summary Of echocardiographic findings In tamponade | 119 | ||
| 2D | 119 | ||
| Doppler | 120 | ||
| Constrictive pericarditis | 120 | ||
| Differentiate Constrictive Pericarditis from Restrictive Cardiomyopathy (Figure 15.3) | 121 | ||
| Aortic Atherosclerosis Aneurysm Dissection | 125 | ||
| Atherosclerosis | 125 | ||
| Thoracic aortic dilatation/aneurysm | 126 | ||
| Thoracic aortic dissection | 126 | ||
| Diagnostic information | 127 | ||
| Type A (Stanford): | 127 | ||
| Type B (Stanford): | 128 | ||
| Differentiate True from False Lumen by: | 128 | ||
| Assessment post-dissection repair | 129 | ||
| Adult Congenital Heart Disease | 131 | ||
| Simple AnomAlies | 131 | ||
| Atrial Septal Defects (ASDs) | 131 | ||
| Types | 131 | ||
| Ventricular Septal Defects (VSDs) | 133 | ||
| Types of VSDs | 133 | ||
| Patent Ductus Arteriosus (PDA) | 136 | ||
| Coarctation of the Aorta | 137 | ||
| Congenital AS | 137 | ||
| Pulmonic Stenosis (PS) | 139 | ||
| Complex anomalies | 140 | ||
| Ebstein's Anomaly (Figure 17.7) | 140 | ||
| Tetralogy of Fallot | 141 | ||
| Late Reoperations for Transposition of the Great Arteries (TGA) | 143 | ||
| Single Ventricle | 144 | ||
| Intracardiac masses and objects | 147 | ||
| Masses and objects | 147 | ||
| In General, Identify: | 147 | ||
| To Better Define the Mass or Object, Identify: | 147 | ||
| Common Pseudomasses and Normal Variants | 147 | ||
| ASA | 148 | ||
| Lipomatous Hypertrophy of IAS | 148 | ||
| PFO | 148 | ||
| Thrombi | 148 | ||
| Tumors | 150 | ||
| Man-Made Devices | 151 | ||
| Artifacts and Pitfalls | 157 | ||
| Artifacts and anatomic pitfalls | 157 | ||
| 2D Imaging Artifacts | 157 | ||
| Doppler Imaging Artifacts | 160 | ||
| Color Imaging Artifacts | 162 | ||
| Is the Visualized Structure ``Real´´ or Artifact? | 162 | ||
| Anatomic pitfalls (e.g., anatomic structures mimicking pathology) | 163 | ||
| Right Atrium (Figures 19.5 and 19.6) | 163 | ||
| Left Atrium (Figures 19.7 and 19.8) | 165 | ||
| Right Ventricle | 166 | ||
| LV and AV (Figures 19.10 and 19.11) | 166 | ||
| Man-Made Objects in Heart | 168 | ||
| Equations and Calculations | 169 | ||
| Doppler flow calculations | 169 | ||
| Pressure gradients and calculated pressure estimates | 172 | ||
| Intraoperative 3D TEE | 173 | ||
| Modes of 3D echocardiography | 173 | ||
| Real-Time 3D Imaging | 173 | ||
| Reconstructed 3D Imaging | 174 | ||
| Optimizing images | 175 | ||
| Valve imaging | 176 | ||
| MV | 176 | ||
| AV | 177 | ||
| TV | 177 | ||
| PV | 177 | ||
| LV Imaging | 178 | ||
| Imaging to guide catheter-based procedure | 179 | ||
| TAVR | 179 | ||
| Septal Defect or Paravalvular Leak Closure Devices | 179 | ||
| LAA Closure | 180 | ||
| Mitra Clip | 180 | ||
| Index | 181 | ||
| Back End Sheet | ES4 |