A Practical Approach to Transesophageal Echocardiography.

Cover -- Title Page -- Copyright -- Dedication -- Contributors -- Preface -- Contents -- SECTION I: ESSENTIALS OF 2D IMAGING -- 1. Principles and Technology of Two-Dimensional Echocardiography -- INTRODUCTION -- PHYSICAL PROPERTIES OF SOUND WAVES -- Vibrations -- Amplitude -- Frequency and Wavelength -- Propagation Velocity -- WHAT IS SO SPECIAL ABOUT ULTRASOUND? -- INTERACTIONS OF SOUND AND TISSUE -- Reflection -- Refraction -- Attenuation -- TRANSDUCER DESIGN AND BEAM FORMATION -- Transducer Components -- Formation of Ultrasound Waves: The Piezoelectric Crystal -- The Three-Dimensional Ultrasound Beam -- Resolution -- Extraneous Sound Beams -- SIGNAL RECEPTION AND PROCESSING -- Cycling of Transducer Transmit and Receive Modes -- Electrical Processing -- DISPLAY FORMATS -- The Golden Rule: Time Is Distance -- Amplitude Mode -- Brightness Mode -- Motion Mode -- 2D Echocardiography -- 2D SCAN SYSTEMS -- Linear Scanners -- Sector Scanners -- CREATING THE 2D IMAGE -- Imaging a Sector -- Image Quality and Dynamic Motion -- Image Quality versus Dynamic Motion -- ADVANCEMENTS -- Harmonic Imaging -- 3D Imaging -- TISSUE DOPPLER AND SPECKLE TRACKING -- Tissue Doppler Imaging -- Strain, Strain Rate, and Speckle Tracking -- Speckle Tracking -- SUMMARY -- 2. Two-Dimensional Examination -- PROBE MANIPULATION -- MULTIPLANE IMAGING ANGLE -- PROBE INSERTION -- GOALS OF THE EXAMINATION -- THE COMPREHENSIVE EXAMINATION -- Midesophageal Ascending Aortic Short-Axis View -- Midesophageal Right Pulmonary Vein View -- Midesophageal Ascending Aortic Long-Axis View -- Midesophageal Aortic Valve Short-Axis View -- Midesophageal Right Ventricular Inflow-Outflow -- Midesophageal-Modified Bicaval Tricuspid Valve View -- Midesophageal Aortic Valve Long-Axis View -- Midesophageal Bicaval View -- Midesophageal Right and Left Pulmonary Vein View.

Midesophageal Five-Chamber View -- Midesophageal Four-Chamber Views -- Midesophageal Mitral Commissural View -- Midesophageal Two-Chamber View -- Midesophageal Left Atrial Appendage View -- Midesophageal Left Pulmonary Vein View -- Midesophageal Long-Axis View -- Transgastric Basal Short-Axis View -- Transgastric Midpapillary Short-Axis View -- Transgastric Apical Short-Axis View -- Transgastric Two-Chamber View -- Transgastric Long-Axis View -- Transgastric Right Ventricular Inflow View -- Deep Transgastric Five-Chamber View -- TG Right Ventricular Basal View -- TG Right Ventricular Inflow-Outflow View -- Descending Aorta Short-Axis View -- Upper Esophageal Aortic Arch Long-Axis View -- Upper Esophageal Aortic Arch Short-Axis View -- Descending Aorta Long-Axis View -- REAL-TIME BIPLANE VIEWS -- THE ABBREVIATED CORE EXAMINATION -- SUMMARY -- 3. Left Ventricular Systolic Performance and Pathology -- MEASUREMENTS OF LV SIZE-WALL THICKNESS, CHAMBER SIZE, AND LV MASS -- Left Ventricular Wall Thickness -- Relative Wall Thickness -- Chamber Size (LV Diameter) -- Chamber Size (LV Volume) -- Left Ventricular Mass -- QUANTITATIVE MEASURES OF LEFT VENTRICULAR SYSTOLIC PERFORMANCE -- OTHER MEASURES OF LEFT VENTRICULAR SYSTOLIC FUNCTION -- Assessing Left Ventricular Systolic Function With Doppler Techniques -- VENTRICULAR PATHOLOGY -- Cardiomyopathies -- Left Ventricular Hypertrophy -- Left Ventricular True Aneurysm -- Left Ventricular Pseudoaneurysm -- CONCLUSION -- 4. Diagnosis of Myocardial Ischemia -- ANATOMY AND PATHOPHYSIOLOGY OF THE MYOCARDIAL BLOOD SUPPLY -- Coronary Anatomy -- Variations in Coronary Anatomy and Main Distribution Types -- Echocardiographic Assessment of Coronary Arteries -- Detection of Coronary Artery Pathology -- PHYSIOLOGIC BASIS FOR THE DETECTION OF ISCHEMIA -- Clinical Syndromes of Myocardial Ischemia.

ECHOCARDIOGRAPHIC ASSESSMENT OF ISCHEMIA -- Anatomic Localization of Ischemia: The 17-Segment Model -- Echocardiographic Imaging of the 17 Myocardial Segments -- Coronary Perfusion of LV Segments -- Assessment and Grading of Regional Wall Contraction Abnormalities -- Important Methodologic Aspects of Wall Contraction Analysis and Potential Pitfalls -- Limitations of Echocardiographic Detection of Myocardial Ischemia -- Alternative Echocardiographic Methods for Detection of Ischemia -- Right Ventricular Ischemia -- COMPLICATIONS OF MYOCARDIAL ISCHEMIA -- SUMMARY -- SECTION II: ESSENTIALS OF DOPPLER ECHO -- 5. Doppler Technology and Technique -- INTRODUCTION -- DOPPLER FREQUENCY SHIFT -- The Doppler Effect -- Signal Frequency and Blood Flow -- DOPPLER ANALYSIS -- The Doppler Equation: Linking the Frequency Shift to Velocity -- Implications of Beam Orientation -- Clinical Caveats in Transesophageal Echocardiographic Doppler Examinations -- Isolating the Doppler Frequency Shift -- PRESENTATION OF DOPPLER DATA -- Audible Broadcast -- Spectral Display -- DOPPLER TECHNIQUES -- Pulsed-Wave Doppler -- Continuous-Wave Doppler -- Color Flow Mapping -- SUMMARY -- 6. Quantitative Doppler and Hemodynamics -- VOLUMETRIC FLOW CALCULATIONS -- Doppler Measurements of Stroke Volume and Cardiac Output -- Regurgitant Volume -- Intracardiac Shunts -- Valve Area: The Continuity Equation -- INTRACARDIAC PRESSURES AND PRESSURE GRADIENTS: THE BERNOULLI EQUATION -- Assessment of Valvular Disease -- Measurement of Intracavitary Pressures -- Vascular Resistance -- Determination of Filling Pressures -- HEART RHYTHM -- SUMMARY -- 7. Echocardiographic Evaluation of Ventricular Diastolic Function -- INTRODUCTION -- BASICS OF DIASTOLIC PHYSIOLOGY -- Intrinsic Myocardial Factors Affecting Diastolic Performance -- Extrinsic Nonmyocardial Factors Affecting Diastolic Performance.

PATHOPHYSIOLOGY OF DIASTOLIC DYSFUNCTION AND PROGRESSION OF DISEASE -- ECHOCARDIOGRAPHIC EVALUATION OF LEFT VENTRICULAR DIASTOLIC FUNCTION -- Two-Dimensional Echocardiography -- Doppler Echocardiographic Evaluation of LV Filling -- Influence of Physiologic Variables on Doppler Flow Profiles -- Assessment of Diastolic Function in Special Clinical Scenarios -- Right Ventricular Diastolic Function -- Pericardial Diseases: Constrictive Pericarditis and Cardiac Tamponade -- A PRACTICAL APPROACH TO DIASTOLIC FUNCTION ASSESSMENT IN THE PERIOPERATIVE PERIOD -- SUMMARY -- SECTION III: VALVULAR DISEASE -- 8. Mitral Regurgitation -- INTRODUCTION -- ANATOMY -- NOMENCLATURE -- ETIOLOGY AND MECHANISM OF MR -- APPROACH TO THE TRANSESOPHAGEAL ECHOCARDIOGRAPHY EVALUATION OF MR -- Where on the Mitral Valve Is the MR and What Is the Mechanism of MR? -- How Severe Is the MR? -- PITFALLS IN THE EVALUATION OF MR -- SECONDARY (FUNCTIONAL) MR -- CONCLUSION -- 9. Mitral Valve Stenosis -- INTRODUCTION -- MITRAL VALVE ANATOMY -- ETIOLOGY OF MITRAL STENOSIS -- TRANSESOPHAGEAL ECHOCARDIOGRAPHIC EVALUATION OF MITRAL STENOSIS -- Two-Dimensional Echocardiography -- Physiologic Assessments -- Advanced Concepts That May Be Helpful in Difficult Cases -- A PRACTICAL APPROACH TO THE EVALUATION OF MITRAL STENOSIS -- Three-Dimensional Echocardiographic Evaluation of Mitral Stenosis -- Use of Echocardiography for New Procedures -- SUMMARY -- 10. Mitral Valve Repair -- INDICATIONS -- Primary versus Secondary Mitral Regurgitation -- ECHOCARDIOGRAPHIC EVALUATION -- The Prerepair Evaluation -- Help in Planning the Surgical Procedure -- MITRAL VALVE REPAIR TECHNIQUES -- The Fundamental Goals of MV Repair for Type II Valve Dysfunction -- 7. Repair Technique of Type I Valve Dysfunction -- 8. Repair Technique of Type III Valve Dysfunction -- Repair Technique for Carpentier Type I Valve Dysfunction.

Repair Technique for Carpentier Type III Valve Dysfunction -- Postrepair TEE Examination -- Preweaning From Bypass TEE Examination -- Postbypass TEE Examination -- Identification of the Circumflex Coronary Artery Perfusion -- Checking for Complete Deairing of the Left Ventricle -- Residual Mitral Regurgitation -- Postrepair Mitral Stenosis -- Screening for Potential Complications -- SUMMARY -- 11. Aortic Regurgitation -- ETIOLOGY AND MECHANISMS OF AORTIC REGURGITATION -- HEMODYNAMICS OF AORTIC REGURGITATION -- ECHOCARDIOGRAPHIC EVALUATION OF THE AORTIC VALVE -- RECOMMENDED VIEWS -- APPROACHES TO THE QUANTITATIVE ASSESSMENT OF AORTIC REGURGITATION -- Color Flow Doppler -- Calculation of Regurgitant Volume, Fraction, and Orifice Area -- Pulsed- and Continuous Wave Doppler -- Special Clinical Situations -- SUMMARY -- REFERENCES -- 12. Aortic Stenosis -- INTRODUCTION -- PATHOPHYSIOLOGY -- ECHOCARDIOGRAPHIC EVALUATION OF THE AORTIC VALVE -- Quantitative Doppler Assessment of Aortic Stenosis -- Planimetry of the Aortic Orifice -- SPECIAL CONSIDERATIONS -- Pressure Recovery -- Systemic Hypertension and Arterial Compliance -- Classical and "Paradoxical" Low-Flow, Low-Gradient Aortic Stenosis -- Assessment of Aortic Stenosis Gradient in Aortic Regurgitation -- Pre- and Postoperative Subaortic Obstruction -- TECHNICAL CONSIDERATIONS -- SUMMARY -- 13. Prosthetic Valves -- INTRODUCTION -- ROLE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE EVALUATION OF PROSTHETIC CARDIAC VALVES -- TECHNICAL CONSIDERATIONS IN PERFORMING TEE EXAMINATIONS OF PROSTHETIC VALVES -- ECHOCARDIOGRAPHIC CHARACTERISTICS OF THE INDIVIDUAL PROSTHETIC CARDIAC VALVE TYPES -- Mechanical Heart Valves -- Biologic Valves or Tissue Valves -- CLINICAL CAVEATS FOR THE ECHOCARDIOGRAPHIC DIAGNOSIS OF PROSTHETIC VALVE DYSFUNCTION -- CONCLUSION.

14. Right Ventricle, Right Atrium, Tricuspid and Pulmonic Valves.

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