A systematic Transesophageal Echocardiography (TEE) examination involves standard tomographic planes acquired from three primary windows: High Esophageal (HE), Mid-Esophageal (ME), and Transgastric (TG) (including Deep Transgastric). The following table summarizes the required views, typical angles, and probe maneuvers for the requested cardiac structures.

Structure	TEE Window	View	Typical Angle	Probe Maneuver
Mitral Valve	Mid-Esophageal	4-Chamber	0°–20°	Advance/withdraw to center valve; probe behind LA [1-3].
	Mid-Esophageal	Commissural	45°–75°	Rotate plane from 0° view; shows P3, A2, and P1 scallops [3-5].
	Mid-Esophageal	2-Chamber	60°–90°	Rotate plane; shows anterior and inferior walls [1-3].
	Mid-Esophageal	Long-Axis	120°–150°	Rotate plane; evaluates A2/P2 scallops and LVOT [2-4].
	Transgastric	Short-Axis	0°	Advance to stomach; anteflex probe tip for "en face" view [3, 6, 7].
	Transgastric	Long-Axis	90°–135°	Rotate plane from TG short-axis; evaluates LVOT and AV [3, 6].
Tricuspid Valve	Mid-Esophageal	4-Chamber	0°	Turn probe rightward (clockwise) from ME 4CH [8-10].
	Mid-Esophageal	RV Inflow/Outflow	60°–90°	Turn rightward and rotate plane; shows anterior/posterior leaflets [2, 9].
	Mid-Esophageal	Bicaval	90°	Rotate plane and turn right; views IAS and TV inflow [7, 11].
	Transgastric	RV Inflow (Right Heart)	90°	From TG short-axis, turn probe rightward and rotate plane [6, 12].
Aortic Valve	High Esophageal	Long-Axis	120°	Withdraw slightly from ME LAX to see distal ascending aorta [4, 11].
	Mid-Esophageal	Short-Axis	30°–60°	Withdraw probe slightly from ME 4CH or flex; shows three cusps [2, 11, 13].
	Mid-Esophageal	Long-Axis	120°–150°	Rotate plane; evaluates valve, root, and STJ [2, 4, 13].
	Deep Transgastric	5-Chamber	0°–20°	Advance deep; use maximum anteflexion while withdrawing [6, 14, 15].
Pulmonary Valve	High Esophageal	PA View	0°–20°	Withdraw to high esophagus; turn toward the patient’s left [2, 9, 11].
Pulmonary Valve	Mid-Esophageal	RV Outflow	60°–90°	Turn leftward from ME long-axis or use RV inflow/outflow view [2, 9].
LAA	Mid-Esophageal	AV Level (Short-Axis)	30°–60°	Withdraw slightly from ME 4CH; LAA is adjacent to the AV [11, 16, 17].
LAA	Mid-Esophageal	Rotational Scan	0° → 135°	Systematically rotate plane through angles to exclude thrombus [16, 18, 19].
Pulmonary Veins	Mid-Esophageal	Left Upper (LSPV)	0°–30°	Turn probe left (counterclockwise); adjacent to LAA [11, 20, 21].
	Mid-Esophageal	Left Lower (LIPV)	0°–30°	Advance probe a few centimeters from the LSPV view [20].
	Mid-Esophageal	Right Upper (RUPV)	0° or 90°	Turn probe right (clockwise); RUPV often seen in bicaval view [2, 11, 22].
	Mid-Esophageal	Right Lower (RIPV)	0° or 90°	Advance probe from the RUPV position [11].
Aorta	High Esophageal	Arch/Ascending	0° or 90°	From proximal descending aorta, turn rightward to see arch [11, 21, 23].
	High/Mid Esoph	Descending (SAX)	0°	Turn posteriorly; slowly withdraw from transgastric to arch [24, 25].
	High/Mid Esoph	Descending (LAX)	90°	Rotate imaging plane from the short-axis descending view [25, 26].
PFO / Bubble Study	Mid-Esophageal	Bicaval View	90°	Best for interatrial septum; turn probe right [7, 11, 27].
PFO / Bubble Study	Mid-Esophageal	4-Chamber	0°	Inject agitated saline at rest and with release of Valsalva [11, 28, 29].
LV Function	Mid-Esophageal	4, 2, & LAX	0°, 60°, 120°	Standard rotation series; evaluates all segments [1, 30, 31].
LV Function	Transgastric	Short-Axis	0°	Standard view for global/regional function at papillary level [6, 7, 30].
RV Function	Mid-Esophageal	4-Chamber	0°	Turn rightward to center the RV; assesses size and contractility [8, 9, 32].
	Mid-Esophageal	RV Outflow	60°–90°	Assesses RV outflow tract and anterior wall function [2, 9].
	Transgastric	Short-Axis	0°	Turn rightward from TG LV view; evaluates RV size and function [6].

TEE Window	View	Typical Angle	Probe Maneuver
Mid-Esophageal	4-Chamber	0°–20°	Advance/withdraw to center valve; probe behind LA [1-3].
Mid-Esophageal	Commissural	45°–75°	Rotate plane from 0° view; shows P3, A2, and P1 scallops [3-5].
Mid-Esophageal	2-Chamber	60°–90°	Rotate plane; shows anterior and inferior walls [1-3].
Mid-Esophageal	Long-Axis	120°–150°	Rotate plane; evaluates A2/P2 scallops and LVOT [2-4].
Transgastric	Short-Axis	0°	Advance to stomach; anteflex probe tip for "en face" view [3, 6, 7].
Transgastric	Long-Axis	90°–135°	Rotate plane from TG short-axis; evaluates LVOT and AV [3, 6].

TEE Window	View	Typical Angle	Probe Maneuver
Mid-Esophageal	4-Chamber	0°	Turn probe rightward (clockwise) from ME 4CH [8-10].
Mid-Esophageal	RV Inflow/Outflow	60°–90°	Turn rightward and rotate plane; shows anterior/posterior leaflets [2, 9].
Mid-Esophageal	Bicaval	90°	Rotate plane and turn right; views IAS and TV inflow [7, 11].
Transgastric	RV Inflow (Right Heart)	90°	From TG short-axis, turn probe rightward and rotate plane [6, 12].

TEE Window	View	Typical Angle	Probe Maneuver
High Esophageal	Long-Axis	120°	Withdraw slightly from ME LAX to see distal ascending aorta [4, 11].
Mid-Esophageal	Short-Axis	30°–60°	Withdraw probe slightly from ME 4CH or flex; shows three cusps [2, 11, 13].
Mid-Esophageal	Long-Axis	120°–150°	Rotate plane; evaluates valve, root, and STJ [2, 4, 13].
Deep Transgastric	5-Chamber	0°–20°	Advance deep; use maximum anteflexion while withdrawing [6, 14, 15].

TEE Window	View	Typical Angle	Probe Maneuver
High Esophageal	PA View	0°–20°	Withdraw to high esophagus; turn toward the patient’s left [2, 9, 11].
Mid-Esophageal	RV Outflow	60°–90°	Turn leftward from ME long-axis or use RV inflow/outflow view [2, 9].

TEE Window	View	Typical Angle	Probe Maneuver
Mid-Esophageal	AV Level (Short-Axis)	30°–60°	Withdraw slightly from ME 4CH; LAA is adjacent to the AV [11, 16, 17].
Mid-Esophageal	Rotational Scan	0° → 135°	Systematically rotate plane through angles to exclude thrombus [16, 18, 19].

TEE Window	View	Typical Angle	Probe Maneuver
Mid-Esophageal	Left Upper (LSPV)	0°–30°	Turn probe left (counterclockwise); adjacent to LAA [11, 20, 21].
Mid-Esophageal	Left Lower (LIPV)	0°–30°	Advance probe a few centimeters from the LSPV view [20].
Mid-Esophageal	Right Upper (RUPV)	0° or 90°	Turn probe right (clockwise); RUPV often seen in bicaval view [2, 11, 22].
Mid-Esophageal	Right Lower (RIPV)	0° or 90°	Advance probe from the RUPV position [11].

TEE Window	View	Typical Angle	Probe Maneuver
High Esophageal	Arch/Ascending	0° or 90°	From proximal descending aorta, turn rightward to see arch [11, 21, 23].
High/Mid Esoph	Descending (SAX)	0°	Turn posteriorly; slowly withdraw from transgastric to arch [24, 25].
High/Mid Esoph	Descending (LAX)	90°	Rotate imaging plane from the short-axis descending view [25, 26].

TEE Window	View	Typical Angle	Probe Maneuver
Mid-Esophageal	Bicaval View	90°	Best for interatrial septum; turn probe right [7, 11, 27].
Mid-Esophageal	4-Chamber	0°	Inject agitated saline at rest and with release of Valsalva [11, 28, 29].

TEE Window	View	Typical Angle	Probe Maneuver
Mid-Esophageal	4, 2, & LAX	0°, 60°, 120°	Standard rotation series; evaluates all segments [1, 30, 31].
Transgastric	Short-Axis	0°	Standard view for global/regional function at papillary level [6, 7, 30].

TEE Window	View	Typical Angle	Probe Maneuver
Mid-Esophageal	4-Chamber	0°	Turn rightward to center the RV; assesses size and contractility [8, 9, 32].
Mid-Esophageal	RV Outflow	60°–90°	Assesses RV outflow tract and anterior wall function [2, 9].
Transgastric	Short-Axis	0°	Turn rightward from TG LV view; evaluates RV size and function [6].

Advancement/Withdrawal: Moves the probe deeper into the stomach or higher in the esophagus [13, 33].
Rotation: Electronic movement of the imaging plane from 0° to 180° [11, 34].
Turning (Left/Right): Physical rotation of the probe handle (clockwise for right, counterclockwise for left) [11, 35, 36].
Flexion/Extension: Using the large wheel to angle the transducer tip anteriorly (flexion) or posteriorly (extension) [34, 36].