A long axis image of a normal Left Ventricle (LV), the main pumping chamber of the heart, is one of several views used to assess the function of the heart and its components. One of the many advantages of Transoesophageal Echocardiography (TOE) is that it can be used during heart and other operations for this purpose.
Another long axis image of the LV from a different angle.
​…and from yet another angle which also gives useful views of the Mitral and Aortic Valves.
​While the previous images were long axis or ‘vertical’ sections of the LV, this is a short axis or ‘horizontal’ section thereof. We call this ‘The Doughnut’ for obvious reasons. Multiple views are needed when assessing the structure or function of the heart and its components.
​A short axis view of an overworked and thus severely thickened LV in a patient with longstanding, untreated high blood pressure.
​A two dimensional (2D) short axis image of a normal Aortic Valve (AV) as if viewed from above the valve. The three cusps are seen opening and closing during each cardiac cycle.
​A 2D long axis image of a normal AV as if viewed from the side.
​A heavily calcified AV, hardly opening and not closing effectively during each cardiac cycle. This is referred to as Aortic Stenosis and Aortic Incompetence respectively.
​Colour Flow Doppler shows the direction of blood flow through the heart and across valves.  Blue indicates flow away from the sonar probe placed in the patient’s oesophagus while red indicates flow towards it. Haphazard, turbulent flow above and below this calcified and leaking AV is indicated by a mosaic of red, yellow and blue.
​A diseased AV has been replaced with a bioprosthesis.  The three leaflets of this type of artificial valve are handmade from bovine (beef) or porcine (pig) pericardium and are mounted on a silastic ring which gets sown into position by the surgeon.
​One of the various views used in assessing the form and function of the Mitral Valve (MV). While the AV has three leaflets the MV has only two.
​Another view of the MV showing the chords which stretch between the wall of the LV and the free edges of the MV leaflets and hold the leaflets in position.
​Yet another angle from which to view the MV.
​One of the leaflets of this MV has broken loose from one or more of the chords keeping it in position. The valve then loses its ability to ensure flow in one direction only and a severe backflow results when the LV contracts. This is Mitral Incompetence due to a flail segment of a leaflet.
​Colour Flow Doppler shows a large turbulent jet of reversing flow. This is a serious condition which usually requires surgical intervention. In many cases such valves can be repaired but some have to be replaced.
​The same incompetent (leaking) MV with a flail segment of leaflet viewed from a different angle.
​A mechanical prosthesis has been used to replace a diseased MV.  The two leaflets, each with its own hinge mechanism, are made of an alloy which is very durable and are mounted in a sowing ring.
​A three dimensional (3D) image of a mechanical prosthesis in the Mitral position as seen from above. 3D TOE imaging allows us to show dynamic cardiac structures from any perspective using a single display which can be rotated in any direction.
​An intra-atrial myxoma. This is a type of tumor that usually occurs in the Left Atrium and necessitates surgical removal.
​Another 2D image of the same myxoma. In this case the Left Atrium is almost obliterated.
​The  same myxoma in 3D. While multiple different 2D images are needed to afford the sonographer a three dimensional concept  of a structure this single  image can be viewed from all angles on the screen of the sonar machine.