Grading Severity

Module 1 – How are TEE images created? – The basic physics of ultrasound

Module 1 – How are TEE images created? – The basic physics of ultrasound - Overview

Sound and ultrasound
Definitions
The characteristics of waves
Wavelength
Frequency
Amplitude
Propagation Velocity
The effects of tissue on ultrasound
Reflection
Refraction
Scatter
Attenuation
Effects of Ultrasound on Tissue
Imaging Modalities: How ultrasound images are created
Generation of a 2D image
Resolution
Principles of doppler imaging
Modes of Doppler Imaging: Overview
Pulsed Wave Doppler: Spectral Display
Pulsed Wave Doppler: Color Flow Imaging
Continuous Wave Doppler
M Mode Doppler
Ultrasound Transducers
Piezoelectric Crystals
Ultrasound Transducer Design
Image Artifacts
Degraded Image
Missing Structures
Erroneously Perceived Structures
Misplaced Structures
Conclusion

Chapter 3 – TEE Probe Manipulation and Imaging Planes

Chapter 3 – TEE Probe Manipulation and Imaging Planes - Overview

Introduction
Probe insertion and removal
Sedation
Preparation
Inserting the probe
Removing the probe
General anesthesia
Overview
Inserting the probe
Removing the probe
Contradictions and Complications
Probe manipulation
Turning to the left and right
Anteflexion and Retroflexion
Ultrasound plane rotation
Lateral flexion
Image orientation
The Perioperative Perspective
Horizontal imaging planes
Vertical imaging planes
Transgastric imaging planes
Conventional imaging planes

Chapter 4 - Measurements, Equations and Reference Values

Chapter 4 - Measurements, Equations and Reference Values - Overview

Learning objectives
Stroke volume
Ejection Fraction: Modified Simpson's calculation
Fractional Area Change
Fractional Shortening
Right Ventricular Systolic Pressure & Pulmonary Artery Systolic Pressure
Shunt ratio
Gradient: The Modified Bernoulli Equation
dP/dt
PISA: Proximal Isovelocity Surface Area
Regurgitant Orifice Area
Regurgitant Volume
Pressure Half Time
Underlying Principles
Mitral Valve Area by Pressure Half Time
Aortic Regurgitation Severity Assessment by Pressure Half Time
The Continuity Equation
Vena Contracta
Reference values
Mitral valve
Aortic valve
Left ventricle
Aorta
Conclusion
Questions

Chapter 5 - The Mitral Valve

Chapter 5 - The Mitral Valve - Overview

Learning objectives
Anatomy
Overview
The Annulus
Leaflet Structure
Leaflet Function
The Tendinous Cords
The Tendinous Cords
Primary, secondary and tertiary cords
Papillary Muscles
Aorto-mitral Continuity
TEE views
Mid Esophageal 4 chamber view
Mid Esophageal Mitral Commissural view
Mid Esophageal 2 Chamber view
Mid Esophageal Long Axis View
Transgastric Basal SAX view
Transgastric 2 Chamber view
Mitral Regurgitation
Introduction
Mechanisms
Quantification
Introduction
Vena Contracta
Flow Convergence
Other Color Flow Doppler Methods
Spectral Dopppler
Grading Severity
Mitral Stenosis
Introduction
Mechanisms
Quantification
Introduction
2D Assessment
Spectral Doppler Assessment
Grading Severity
Conclusions
Quiz questions

Chapter 6: The Aortic Valve

Chapter 6: The Aortic Valve - Overview

Learning objectives
Anatomy
Introduction
The Aortic Valve Annulus
The Sinuses of Valsalva
The Aortic Valve Leaflets
The Commissures
Aorto-mitral Continuity
TEE Views
Mid Esophageal Aortic Valve Short Axis
Mid Esophageal Aortic Valve Long Axis
Transgastric Long Axis
Deep Transgastric Long Axis
Aortic Stenosis
Introduction
Mechanism
Overview of Mechanisms
Calcific Aortic Stenosis
Bicuspid Aortic Stenosis
Rheumatic Aortic Stenosis
Quantification
Quantification Overview
Velocity & Gradient
Aortic Valve Area
Velocity Ratio
Grading Severity
Aortic Regurgitation
Introduction
Mechanisms
Overview of Mechanisms
Leaflet Abnormalities
Root Dilation
Quantification Overview
Jet/LVOT
Continuous Wave Doppler
Descending Aorta Flow Reversal
Vena Contracta
Regurgitant Volume, Fraction and Orifice Area
Left Ventricular Size & Function
Grading Severity
Conclusion
Quiz

Chapter 7: The Left Ventricle

Chapter 7: The Left Ventricle - Overview

Introduction
Learning Objectives
Anatomy
Introduction
Gross Anatomy
Segmental Anatomy
Blood Supply
TEE Views
Mid Esophageal 4 chamber view
Mid Esophageal mitral commissural
Mid Esophageal 2 chamber view
Mid Esophageal long axis view
Transgastric mid short axis
Transgastric basal short axis
Transgastric 2 chamber
Assessment of the Left Ventricle
Overview
Chamber Quantification
Overview
Cavity Dimensions
Wall Thickness
Cavity Volume
Left Ventricular Mass
Systolic Function
Fractional Shortening
Fractional Area Change
Ejection Fraction
dP/dt
Tissue Doppler Assessment
Regional Wall Assessment
Diastolic Function
Quantification Overview
Conclusion
Quiz

Chapter 8: The Right Ventricle

Chapter 8: The Right Ventricle - Overview

Introduction
Anatomy
Introduction
Gross Anatomy
Inlet Portion
Apical trabecular component
Outlet portion
Blood Supply to the Right Ventricle
Blood supply
TEE Views
Describing the right ventricle
Midesophagael Four Chamber
Midesophagael RV inflow outflow
Trangastric Mid Sax
Trangastric RV inflow
Assessment of the Right Ventricle
Overview
Dimensions
Systolic Function
Overview
Myocardial Performance Index
TAPSE
Fractional Area Change
Tricupspid Annular Velocity
dP/dt
Diastolic Function
Overview
TV inflow
Tissue Doppler Imaging
Summary
Pulmonary Artery Systolic Pressure
Grading Severity
Pathology
Overview
Volume Overload
Pressure Overload
Intrinsic Disease
Conclusion
Quiz questions

Chapter 9: The Aorta

Chapter 9: The Aorta - Overview

Introduction
Learning Objectives
Anatomy
Structure
Anatomical Relations
Vessels and Dimensions
Vessels
Dimensions
TEE Views
Overview
ME Asc Aortic SAX
ME Asc Aortic LAX
ME Desc Aortic SAX
ME Desc Aortic LAX
UE Aortic Arch LAX
UE Aortic Arch SAX
Pathology
Atheroma
Dissection
Overview
Classification
Imaging
Aneurysm
Coarctation
Intra Aortic Ballon Pump
Conclusion
Quiz questions

Chapter 10: Other Structures of Interest

Chapter 10: Other Structures of Interest - Overview

Introduction
Left Atrium, Left Atrial Appendage & Pulmonary Values
Left Atrium
Left Atrial Appendage
Anatomy of the Left Atrial Appendage
TEE Views of the Appendage
Clinical Significance
Pulmonary Veins
Pulmonary Venous Anatomy
TEE Views
Clinical Significance
Right Atrium, Atrial Septum & Cavae
Right Atrium
Atrial Septum
Superior and Inferior Cavae
Coronary Sinus
Eustachian Valve & Crista
Tricuspid Valve
Tricuspid Valve Anatomy
TEE Views
Clinical Significance
Pulmonic Valve
Pulmonic Valve Anatomy
TEE Views
Clinical Significance
Pericardium
Conclusion
Quiz questions

CME

CME - Overview

Welcome

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