The 4-Valve View

Real-time 3D transesophageal imaging has advanced significantly over the past several years. In our laboratory, we currently use real-time 3D transesophageal imaging in addition to multiplane 2D imaging in all of our transesophageal imaging. As the equipment and software continue to advance, new imaging modes and views become available.Recently we started using a new view, which we named the 4V (4-valve) view. We found that it can be acquired in all patients undergoing a transesophageal imaging and provides a new perspective on cardiac anatomy (Figure 1 and online-only Supplemental Video).Figure 1. The 4-valve (4V) view. AV indicates aortic valve; MV, mitral valve; PV, pulmonic valve; and TV, tricuspid valve.The 4V view is most easily acquired from the midesophageal position, at a transducer angle of 0°. A 4-chamber view is the starting 2D view (Figure 2A). Once an adequate image is attained, the …