PSS Base of the heart

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Your probe is aimed toward the right shoulder of the patient, the notch between 1 and 2 o'clock.

PSS aortic valve legends.jpg
-RV: right ventricle, on the top of the image. This is the RV outflow tract, which is connected to the main pulmonary artery via the PV.

-PV: pulmonic valve, at 1-2 o'clock on the right of the image, connects the RV to the main pulmonary artery. PSS is a good view to look for a pulmonic regurgitation or stenosis, since your ultrasound beam is well aligned on the flow across the PV.

-TV: tricuspid valve, at 9 o'clock on the left of the image, between the right atrium (RA) and right ventricle (RV). PSS is a good view to look for tricuspid regurgitation, you may have a good Doppler alignement with the regurgitant TV jet, to estimate RV systolic pressure.

-RA: right atrium, on the bottom left of the image

-LA: on the bottom of the image, behind the aortic valve

-Ao V: aortic valve, at the center of the image. You should see the three cusps: the "mercedes" sign. The non-coronary cusp is adjacent to the inter-atrial septum, the right cusp is on the top, next to the right ventricle. In biscupid aortic valve, you will only visualize two cusps, but a raphe often persists between the two fused cusps, which can be misleading.

 Schema aortic valve tricusp.jpg      Normal tricuspid aortic valve                   Schema aortic valve bicusp.jpg Bicuspid aortic valve with median raphe 

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