A Novel View for Performing Left Atrial Strain Analysis by Transesophageal Echocardiography

JOURNAL TITLE: Journal of Perioperative Echocardiography

1. Kedar Bangal
Publishing Year
Author Affiliations
    1. Department of Cardiac Anaesthesiology, Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka, India
  • Article keywords
    Echocardiography, Perioperative transesophageal echocardiography, Speckle tracking echocardiography, Transesophageal echocardiography, Transthoracic echocardiography


    Aim: To devise a technique for producing a view that can be utilized to perform strain analysis of the left atrium (LA) by transesophageal echocardiography (TEE). Background: Advancement in the field of echocardiography has led to the development of strain and speckle tracking. The magnitude of LA deformation is utilized to determine the diastolic function by means of strain rate imaging. It is difficult to accommodate all the borders of LA in an image by TEE. Technique: Hereby, I would like to present a TEE view that is identical to the subcostal view of transthoracic echocardiography (TTE). This may be named as “deep transgastric four-chamber view” (deep TG-4C), and it is unique compared to the 28 TEE views. I have devised a technique for producing this view on TEE, and I have used it to analyze LA strain intraoperatively for 50 cases. Echocardiography was performed using a CVx TEE probe (Philips Healthcare, Andover, Massachusetts) and strain analysis was performed by Tomtec Autostrain software. The exact maneuvers to produce this view are also devised by me. Conclusion: The deep TG-4C view is helpful in performing LA strain analysis by TEE. Clinical significance: The deep TG-4C view of TEE accommodates all the borders of the LA and is helpful in performing LA strain analysis.

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