To navigate between TEE standard views use the tools provided in the section labelled 'Navigation' (figure).
The navigation section contains a graphical representation of the relationship between the twenty standard two-dimensional transesophageal echocardiography views. Each view is represented as a box with the abbreviated name of the view printed on the inside. Each box contains an omniplane angle icon (figure) that suggests the approximate omniplane angle required to obtain the view. The arrows and other symbols between views indicate the relationship bewteen the views. To learn the meaning of each symbol, click on the check box marked 'View legend' (figure), this will open a descriptive legend to assist you. The views are arranged in the vertical axis by depth with views requiring deeper insertion of the probe located lower on the chart; views arranged horizontally can be found at approximately the same probe depth.
The entire navigation chart can be rescaled and repositioned to make reading easier or to frame certain views, respectively. To rescale the navigation chart, click on the magnifiing glass icons (figure); the magnifiing glass with a plus sign zooms in on the chart while the other zooms out. To move the navigation chart or reframe certain views within it, position your mouse within the chart so that it is not resting over one of the standard view buttons, you should see an open hand icon; click and drag to move the chart. On a PC, the chart can also be moved up and down using your mouse's scrollwheel.
Your current location within the virtual examination is indicated by the position of the blue TEE-plane-shaped icon (figure). This icon will move over and between boxes as you choose to move the probe during the virtual examination. When the examination begins, you should see the current position icon centered over a box labelled 'Hypopharynx'.
To navigate bewteen views you can take one of the following two actions: 1) Click on a box to watch an animated transition from the current view; 2) Click on the drop down menu labelled 'Jump to view' (figure) to move directly to a standard view without an animated transition.
Located in the upper right, the Virtual TEE application contains a three-dimensional rendering of the heart, TEE probe and TEE plane. The three-dimensional rendering of the heart can be viewed from various perspectives: superior, anterior, right, left, and a composite view called 'ant/sup/left/right view' that includes the four aforementioned positions. To change the view, click on one of the buttons under the heading 'Viewing position' (figure).
At each of the standard views, a special feature allows you to interact with and rotate the three-dimensional model. To activate this feature, click on the button labelled 'Interactive model' (figure). Once the three-dimensional model is downloaded you can rotate the model. To rotate the model use one or both of the following approaches: 1) Place your mouse pointer over the model, your pointer should be replaced by arrows (figure). Click and drag your mouse in the direction indicated by the arrows to rotate the model. 2) Click on the direction arrows (figure). By default the interactive model will begin positioned so that you are viewing the heart from the anterior, if at any time you want to return to this view, click on the 'center' button located within the direction arrows (figure).
In the interactive model mode, a wedge of heart corresponding to the TEE plane can be removed to reveal the internal structures of the heart that the TEE plane passes through (figure). To remove the wedge, click on the button labelled 'show interior' (figure). To replace the wedge click on the button labelled 'hide interior'.
Located in the upper right is video playback of actual TEE footage corresponding to the current standard view or transition between views. This footage can be paused by clicking on the pause icon (figure) and restarted by clicking the play icon (figure). The footage can be scrubbed by clicking and dragging the scrubbing bar (figure). Pausing, playing and scrubbing the video footage has a similar effect on the three dimensional animation which is synchronized with the video.