DK2985_C000 1..28 - AlSharqia Echo Club

102 Transesophageal EchocardiographyFigure 5.21 Mid-esophageal view of the left atrial appendage (LAA). The LAA diameter is taken at the ostium near the tip of thepulmonary vein limbus (“coumadin ridge” or “Q-tip” sign) representing the separation between the left upper pulmonary vein(LUPV) from the LAA. The length of the LAA extends from the tip to the line used for measuring the diameter [(A), short-axis; (B),long-axis or length; LA, left atrium] (11).assumed shape and the Teichholz’s method (15) seems tohave the least imprecisions (16) and has been incorporatedin most commercialized echocardiography system on-lineanalysis software as given by the following equation:Volume ¼ d 3 7:02:4 þ d(5:3)To minimize the error caused by too many geometricassumptions,investigators havedeveloped differentmethodsutilizing more measurements available from 2D echocardiography.The ASE now recommends two methods toestimate left ventricular volumes from left ventricularcavity area, and long axis measurements from the fourandtwo-chamber orthogonal views: the modifiedFigure 5.22 Mid-esophageal views of the right upper (A, B) and lower (C, D) pulmonary veins (PV). The measurement is made at1 cm from where the PV enters the left atrium (LA) (RLPV, right lower pulmonary vein; RUPV, right upper pulmonary vein) (11).