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TEE.",{"id":215,"name":216},1,"Course previews",[218,229,234],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},237,{"platform":223,"name":224,"url":225,"size":226},"YouTube","How to use TEE to obain mid-esophageal long-axis views of the aortic root.","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=u2Md7xaNcsQ",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},14.933333333333334,"\u003Cp>This video, taken from our \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Ftransesophageal-echocardiography-essentials\">TEE Essentials course\u003C\u002Fa>, will show you how to obtain a mid-esophageal long-axis view of the aortic root using TEE, how to take measurements, and relevant normal ranges.\u003C\u002Fp>\u003Cp>Taught by \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fteacher\u002Fandrew-r-houghton-md\">Andrew Houghton\u003C\u002Fa>, MD, head of cardiac imaging at Grantham & District Hospital, this course will give you an enormous career boost.\u003C\u002Fp>\u003Cp>Register for a free Medmastery trial and \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Ftransesophageal-echocardiography-essentials\">check it out!\u003C\u002Fa>\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},100.8,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-f2029ba5-7fff-fbdb-f933-68587509486f\">[00:00:00] \u003C\u002Fb>In this lesson, we're going to learn how to assess the aorta in the mid-esophageal long-axis aortic root view. In this view, we can see the aortic root towards the right-hand side of the screen. We can see the aortic valve, and the aortic root at the level of the aortic cannulas, sinus of Valsalva, sinotubular junction, and the proximal tubular ascending aorta. Other nearby structures include \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-f2029ba5-7fff-fbdb-f933-68587509486f\">[00:00:30] \u003C\u002Fb>the left atrium, the mitral valve, anterior leaflet, and posterior leaflet for left ventricle and a portion of the right ventricle. This view is obtained in the mid-esophageal probe position with the probe facing anteriorly to cut through the aortic valve and aortic root. I'd suggest starting with transducer imaging plane angle of 140 degrees. As always, some fine-tuning of the angle might be necessary to optimize \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-f2029ba5-7fff-fbdb-f933-68587509486f\">[00:01:00] \u003C\u002Fb>the image and avoid foreshortening. The optimal long-axis aortic root view is usually found somewhere between 120 and 140 degrees. And this is the view that we're looking for. This has been obtained with transducer imaging plane angle of 136 degrees. We can see the aortic valve very clearly, in the middle of the image. We have the non-coronary cusp in the near field and the right coronary cusp in the far field, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-f2029ba5-7fff-fbdb-f933-68587509486f\">[00:01:30] \u003C\u002Fb>and we can see the aortic root. We should inspect the anatomy of the root carefully to look for any evidence of atheroma, any dilatation, and we'll show you in a moment, how to quantify that. We should also look for any absence of dissection flaps, and also any evidence of supravalvular aortic stenosis. In this view, it might also be possible, sometimes, to see the ostium of the right coronary artery as it arises \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-f2029ba5-7fff-fbdb-f933-68587509486f\">[00:02:00] \u003C\u002Fb>from the sinus of Valsalva. As well as describing the appearance of the aortic root, we should also quantitate its dimensions by measuring its internal diameter in mid-diastole, and we do so at several levels. And the first diameter measurement that we make is at the aortic valve annulus level, where the normal diameter is between 2.0 and 3.1 cm. Next, we should measure the diameter at the level of the sinuses of Valsalva. The normal range here is between 2.4 and 4.0 cm. \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-f2029ba5-7fff-fbdb-f933-68587509486f\">[00:02:30] \u003C\u002Fb>Next, we should measure the sinotubular junction diameter. The normal range being 2.2 to 3.6 cm. We also need to describe the appearance of the sinotubular junction and whether it looks normal or whether there is effacement of the junction, which is what we see in patients with \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cb id=\"docs-internal-guid-f2029ba5-7fff-fbdb-f933-68587509486f\">[00:03:00] \u003C\u002Fb>Marfan syndrome. And finally, we should measure the tubular ascending aorta. The normal diameter here is 2.2 to 3.6 cm. Aortic diameters do vary according to the patient's body size and so it's recommended that the aortic diameter at the sinuses of Valsalva should be indexed for body surface area. And the normal range for the index measurement is 1.8 plus or minus [00:03:30] 0.2 cm \u002F m2.\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. 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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},"Using TEE to get mid-esophageal long-axis aortic root views | Medmastery",{"title":348,"description":213,"image":350},{"alt":281,"title":281,"size":351,"location":354},{"width":352,"height":353},785,439,{"bucket":285,"key":355},"\u002Fmigrated-images\u002FScreen Shot 2017-10-24 at 12.37.35 PM.png",{"id":357,"created":358,"updated":359,"published":358},155,1508844354,1753109542]