DK2985_C000 1..28 - AlSharqia Echo Club

76 Transesophageal Echocardiography(A)(B)LALMCARAAoRCA(C)(D)LALVAoRCAFigure 4.28 (A, B) Upper esophageal short-axis view of the aorta (Ao) and right coronary artery (RCA). (C, D) Long-axis view(LA, left atrium; LMCA, left main coronary artery; LV, left ventricle; RA, right atrium; RV, right ventricle).appears in the near field of the ultrasound sector requiringseveral ultrasound system image adjustments for optimalvisualization. Sector depth should be reduced to 6–8 cm,gain should be reduced and focus should be adjusted tothe near field. Finally, air within the esophagus canreduce image quality if the ultrasound probe tip is notapposed to the wall of the esophagus. Proper probe tipapposition can be ensured through the maintenance ofslight probe tip flexion. However, because the descendingaorta can be tortuous, some alternance between slightanteflexion and retroflexion may occasionally be neededto ensure optimal image quality.It is difficult to localize abnormalities anatomicallywithin the descending thoracic aorta. The level of anyabnormality is typically described in centimetres fromthe incisors (or sometimes from the left subclavianartery origin when seen). The location is furtherdescribed relative to the probe tip in the esophagus(e.g. near-field, far-field, left side, or right side of theaorta at 30 cm).(A)(B)LALVAoRVFigure 4.29ventricle).Mid-esophageal long-axis view at 1358 of the ascending aorta (Ao) (LA, left atrium; LV, left ventricle; RV, right