Figure 1

Multiplane 2D TEE with color Doppler is utilized to identify the mitral valve scallops. Panel A demonstrates a TEE at midesophageal 0 degrees view. In this view one can visualize the A2 and P2 scallops of the mitral valve at the tips of the leaflets. However the scallops visualized depend on the level of depth. At 0 degrees midesophageal view, when the aortic valve is visualized, the A1/P1 scallops are noted at the leaflet tips. When the TEE probe is advanced further into the esophagus past the midesophageal level, the A3/P3 scallops are identified at the leaflet tips [16]. Of note, the A2 scallop of the mitral valve is flail with a posteriorly directed mitral regurgitation jet. Panel B demonstrates a commissural view at 60 degrees. In this view, the lateral most scallop (close to the appendage) is P1. One can also visualize the central, flail A2 scallop. The P3 scallop is also well visualized in this view. The mitral regurgitation originated around the A2 scallops as was seen in the 0 degree view. Panel C is the long axis view between demonstrating the A2 and P2 scallops.