Philipp Blanke et al. JIMG 2015;8:

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Philipp Blanke et al. JIMG 2015;8:612-615 Orthogonal Fluoroscopy Projections The D-shaped mitral annulus is most commonly oriented in a cranial and anterior position with a significant degree of angulation to the right. As with any disc-shaped object in a 3D space, there are numerous orthogonal projections of the annular plane that follow a line of perpendicularity as plotted in the graph: Any point in the RAO to LAO spectrum can be utilized as long as the correct degree of caudal or cranial angulations is matched. Specific projections, for example, parallel to the TT line (perpendicular to the SL distance) referred to as TT view, or through the SL line (perpendicular to TT) referred to as SL view, may be desired. Projection angles are limited by physical restraints of the C-arm and require suitable access to conduct the procedure. Although required angulations to achieve the SL view are in the range of practical C-arm working angles for this patient, the required angulations to achieve the TT view are not. CRA = cranial; LAO = left anterior oblique; RAO = right anterior oblique; other abbreviations in Figure 4. Philipp Blanke et al. JIMG 2015;8:612-615 2015 American College of Cardiology Foundation