10/08/2025
🔍 TEE Tip: Navigating the Descending Aorta Like a Pro
Ever get lost while scanning the aorta on TEE? Here’s your roadmap — straight from ASE/SCA guidelines 🚀
1️⃣ Find your start line:
From mid-esophageal (0–10°), rotate counterclockwise toward the left hemithorax — the aorta sits left of the spine.
2️⃣ Sweep with purpose:
Advance toward the upper abdominal aorta (until it disappears below the diaphragm), then slowly withdraw toward the arch, keeping the aorta centered.
3️⃣ Perfect your short-axis view:
At 0–10°, zoom in, focus near-field, crank up the frequency, and fine-tune gain to spot plaques and intimal detail.
4️⃣ Double-check in long-axis:
Rotate to 90–110° to confirm it’s a true SAX (not an oblique slice) and to separate real plaque from artifact.
5️⃣ Know your landmarks:
Few exist! Report findings by:
• Distance from incisors 🦷
• Which wall faces the esophagus
• Relation to left subclavian origin
6️⃣ Orientation clue:
Intercostal arteries pop up on the right of your image — they confirm you’re in true SAX with left-side probe orientation.
7️⃣ Doppler like a detective:
Color Doppler over suspicious areas, PW Doppler for holodiastolic flow reversal = strong AR evidence when LVOT is tricky.
8️⃣ Watch for pitfalls:
Oblique cuts can fake dilations or flaps. Orthogonal planes are your lie detector. Air in the tracheobronchial tree? Accept the blind spot and use other imaging.
📌 Bottom line: Stay systematic, confirm in two planes, and let landmarks + Doppler be your guides.
