Biplanar transesophageal echocardiography: anatomic correlations, image orientation, and clinical applications

Clinical transesophageal echocardiography is a rapidly expanding diagnostic procedure. Conventional transesophageal endoscopes allow imaging from a single array mounted in the horizontal plane. This article introduces the clinical application of biplanar imaging, which incorporates a second orthogonal longitudinal plane. Our clinical experience with 291 patients who underwent biplanar transesophageal echocardiography is presented. The examination, technique, and resultant anatomic correlations unique to this new examination are discussed and illustrated. The anatomy is displayed in a familiar format comparable to the precordial examination. Biplanar imaging adds substantially to the comprehensive anatomic delineation of certain cardiac structures.