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This video is taken from our Transesophageal Echocardiography Essentials course.",{"id":215,"name":216},1,"Course previews",[218,229,234],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},323,{"platform":223,"name":224,"url":225,"size":226},"YouTube","Assessing the aortic valve using TEE (mid-esophageal long-axis view)","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=HhJAJyC9AJs",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},14.4,"\u003Cp>Learn how to assess the aortic valve (mid-esophageal long-axis view) using TEE in this short video by cardiology expert, Andrew R. Houghton, MD.\u003C\u002Fp>\u003Cp>This video was taken from our CME-accredited \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Ftransesophageal-echocardiography-essentials\" target=\"_self\">Transesophageal Echocardiography (TEE) Essentials\u003C\u002Fa> course taught by Dr Andrew Houghton—cardiac imaging specialist and head of cardiac imaging at Grantham & District Hospital.\u003C\u002Fp>\u003Cp>Check out the \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Ftransesophageal-echocardiography-essentials\" target=\"_self\">TEE Essentials course\u003C\u002Fa> now!\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},148.79999999999998,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:00:00] \u003C\u002Fb>In this lesson, we're going to learn how to obtain the mid-esophageal long-axis view of the aortic valve. In this view, we have the left atrium in the near field, the mitral valve, anterior and posterior leaflets, the left ventricle, the left ventricular outflow tract, the aortic valve, and the aortic root to gather a portion of the right ventricular outflow tract. This view is obtained at the mid-esophageal probe \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:00:30] \u003C\u002Fb>position, with the probe facing anteriorly, to take a cut through the aortic valve. In order to obtain the long-axis view, I'd suggest starting with the aortic valve short-axis view, that we covered in our previous lesson. And this is obtained with transducer imaging plane angle of around 40 degrees, certainly somewhere between 25 and 45 degrees. And once you've obtained this view, then what we need to do is rotate \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:01:00] \u003C\u002Fb>the imaging plane forwards by 90 degrees, to obtain the long-axis view. So here, we now have the mid-esophageal long-axis view. We have the left atrium in the near field, mitral valve, left ventricle, left ventricular outflow tract, aortic valve, and aortic root. We've used a transducer imaging plane angle here of 137 degrees because that gave us the optimal long-axis view, with no foreshortening. \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:01:30] \u003C\u002Fb>Certainly, the optimal view will normally be obtained with an imaging plane somewhere in the region of 120 to 140 degrees. Looking at the aortic valve itself, we can see two cusps, here. The cusp in the far field is the right coronary cusp. The cusp in the near field is either the non-coronary cusp or the left coronary cusp, depending upon whether the probe is turned to the patient's right or the patient's left. \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:02:00] \u003C\u002Fb>So, by adjusting the probe position and turning it left or right, we can sweep back and forth across the valve and bring either the left coronary cusp or the non-coronary cusp into view. In this particular case, what we're seeing is the non-coronary cusp, together with the right coronary cusp. In this view, we can assess the morphology of the aortic valve cusps whether they are not thin or thickened, whether they are calcified, and whether there are any associated \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:02:30] \u003C\u002Fb>abnormalities such as vegetations. We can also assess for mobility of the cusps and how widely they open. Remember to take a look as well at the anatomy of the left ventricular outflow tract for any subvalvular stenosis and also the aortic root to look for any supravalvular stenosis or any aortic root abnormalities. And we'll discuss the aortic root in more detail in our chapter \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:03:00] \u003C\u002Fb>on the aorta. Finally, once we've assessed the anatomy of the aortic valve and neighboring structures, we should apply color Doppler to assess flow through the valve. And here, we have color Doppler applied in a patient who has severe aortic regurgitation, as a consequence of infective endocarditis. And we can see this diastolic, very broad jet of \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:03:30] \u003C\u002Fb>turbulent flow, which corresponds to severe aortic regurgitation. We should also take some measurements in the long-axis view. One of these is the diameter of the left ventricular outflow tract and this measurement is normally taken within half a centimeter of the aortic valve annulus. This measurement is used as part of the continuity equation when calculating effective orifice area of the \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:04:00] \u003C\u002Fb>aortic valve, particularly useful in cases of aortic stenosis. We should also measure the diameter of the aortic annulus, between the hinge points of the aortic valve. In this measurement, together with the previous LVOT diameter measurement, should be taken in early to mid-systole. Other measurements of the aortic root are discussed further in the chapter on the aorta. Finally, let's take a look at a couple of examples of \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-61b97f0d-7fff-9a85-38ce-72eb881d6d37\">[00:04:30] \u003C\u002Fb>pathology. This is a patient with severe aortic stenosis and this mid-esophageal long-axis view of the aortic valve shows thickened and calcified aortic valve cusps, with greatly reduced cusp mobility. And here, we have a patient with infective endocarditis. They have an irregular mobile oscillating vegetation on the ventricular aspect of the non-coronary cusp.\u003C\u002Fp>",{"courses":240,"showAwardsBelow":48},[241],{"id":242,"isFreeCmeCourse":243,"title":244,"type":245,"specialization":246,"teachers":248,"cmeCredits":250,"teacherIllustration":251,"backgroundImage":252,"relativeUrl":253,"lastChanged":254,"created":255,"description":256,"relativeURL":253,"meta":257},2718,false,"Transesophageal Echocardiography Essentials","course",[247],"Ultrasound",[249],"Andrew R. Houghton, MD FRCP",6,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55ea9-9720-419f-ac2a-594a1d7b4d51","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55eaa-a071-40d0-8222-24710a5316b0","\u002Fcourses\u002Ftransesophageal-echocardiography-essentials","1763556396","1462447422","Targeted towards cardiologists in training, internists, anesthesiologists, emergency physicians, cardiac physiologists, and cardiac sonographers this course teaches you everything you need to know about performing a standard TEE exam. You’ll learn when a TEE should be ordered and what needs to be done to ensure the safety of your patient during the process. You’ll also learn how to obtain the standard views and how the standard views can be modified to obtain some of the more atypical views.",{"duration":258,"quizzes":259,"lessons":260},14769,10,65,{"id":262,"name":249,"image":263,"profession":264,"relativeUrl":267,"specializations":268},1590,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef8-716d-4d30-99af-035d10a4581d",{"name":265,"description":266},"Cardiologist","Cardiologist and cardiac imaging specialist at the United Lincolnshire Teaching Hospitals NHS Trust in the UK.","\u002Fteachers\u002Fandrew-r-houghton-md-frcp",[269,247,270,271],"Imaging","Cardiology","Infectious diseases",173,"3m",[275,302,321],{"id":276,"title":277,"text":278,"image":279,"author":287,"path":296,"readDuration":297,"readDurationFormatted":273,"internal":298},1350,"How to Recognize INOCA (ANOCA) on an Exercise Stress Test ","Angina, abnormal stress test, clean coronaries—that's INOCA (or ANOCA), and it carries real risk. Learn to recognize and report it with exercise stress ECG.",{"alt":280,"title":281,"size":282,"location":284},"Illustration of the heart's coronary vasculature showing large coronary arteries and the extensive network of smaller vessels affected in INOCA (ischemia with nonobstructive coronary arteries).","",{"width":283,"height":283},1200,{"bucket":285,"key":286},"public-drupal-medmastery-assets-production","\u002F2026-05\u002FC17(1)_magazine image_0.png",{"id":288,"title":289,"relativeURL":290,"image":291,"professionLong":292,"profession":293,"weight":295},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":294},"Internist",4,"\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,{"created":299,"updated":300,"published":301},1778115738,1778118425,1778118255,{"id":303,"title":304,"text":305,"image":306,"author":312,"path":314,"readDuration":315,"readDurationFormatted":316,"internal":317},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":307,"title":281,"size":308,"location":310},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":309,"height":309},600,{"bucket":285,"key":311},"\u002F2026-04\u002FC121_magazine image.png",{"id":288,"title":289,"relativeURL":290,"image":291,"professionLong":292,"profession":313,"weight":295},{"name":294},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":318,"updated":319,"published":320},1777403036,1777572381,1777412421,{"id":322,"title":323,"text":324,"image":325,"author":330,"path":339,"readDuration":340,"readDurationFormatted":341,"internal":342},1347,"Outpatient care for COPD exacerbations","Most acute COPD exacerbations can be managed with outpatient treatment. Learn how to treat mild and moderate COPD exacerbations—and when to escalate care.",{"alt":326,"title":281,"size":327,"location":328},"Older patient using a handheld nebulizer to inhale bronchodilator medication during an acute COPD exacerbation",{"width":309,"height":309},{"bucket":285,"key":329},"\u002F2026-04\u002FC133(4)_ exacerbations_magazine image.png",{"id":331,"title":332,"relativeURL":333,"image":334,"professionLong":335,"profession":336,"weight":338},5365,"Siamak Moayedi, MD","\u002Fteachers\u002Fsiamak-moayedi-md","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cf02-1064-4074-817b-0eb5de6ded74","Professor and Director of Medical Student Education, University of Maryland and Course Director, Essential and Critical Procedures, Emergency Medicine.",{"name":337},"Emergency medicine physician",1533,"\u002Fmagazine\u002Facute-copd-exacerbation-treatment",191,"4m",{"created":343,"updated":344,"published":345},1776705362,1776710540,1776710541,{"seo":347,"og":349},{"title":348,"description":213},"How to assess the aortic valve using TEE (mid-esophageal long-axi | Medmastery",{"title":348,"description":213,"image":350},{"alt":281,"title":281,"size":351,"location":354},{"width":352,"height":353},480,356,{"bucket":285,"key":355},"\u002Fmigrated-images\u002Fmag.jpg",{"id":357,"created":358,"updated":359,"published":358},151,1507639286,1748011203]