The regional distribution of myocardial ischemia can be detected as segmental LV wall motion abnormalities by TEE. The entire LV in the 17-segment model can be imaged in long-axis using a combination of the TEE mid-esophageal four-chamber view (a), TEE mid-esophageal two-chamber view (b), and TEE mid-esophageal long-axis view (c). Alternatively, all 17 LV wall segments can be imaged using the TEE transgastric LV short-axis views at the levels of the LV base (d), papillary muscles (e), and apex (not shown). Alternatively, an earlier version of a 16-segment LV model that excludes the apical cap is often used for TEE studies.
LV: left ventricle/left ventricular; TEE: transesophageal echocardiography.
Modified from: Shanewise JS, Cheung AT, Aronson S, et al. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography. J Am Soc Echocardiogr 1999; 12:884.
