# TEE Simulator 3D — Public release sources and scope

Updated 2026-09-21. The public release provides the whole-heart simulator, 28 standard views, seven vascular views, Japanese/English controls and published reference material. It has not undergone specialist review or clinical validation.

## Heart model

See [ATTRIBUTION.md](./ATTRIBUTION.md) for HRA / Visible Human Female source models, CC BY 4.0 attribution, geometry processing and illustrative motion. See [Three.js MIT license](../vendor/THREE-LICENSE.txt).

## Redistributed reference media

These are separate literature cases, not registered to the heart model. No image-derived geometry is claimed for these videos.

### Labelled AV short-axis

Kothavale AA, Yeon SB, Manning WJ. A systematic approach to performing a comprehensive transesophageal echocardiogram. A call to order. BMC Cardiovasc Disord. 2009;9:18. Figure 19.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2694155/figure/F19/

CC BY 2.0: https://creativecommons.org/licenses/by/2.0/

Whole original multi-panel figure, no changes. Panel A identifies NCC/LCC/RCC in TEE approximately 50–60°. Panel B shows TV and C shows PV. This is a different source and case from the aortic cine above.

### ME four-chamber, TG midpapillary, and 3D mitral intervention reference

Maxwell C, Konoske R, Mark J. Emerging Concepts in Transesophageal Echocardiography. F1000Research 2016;5:340.
https://f1000research.com/articles/5-340

Associated video datasets are CC0: https://creativecommons.org/publicdomain/zero/1.0/

Video 1: https://doi.org/10.5256/f1000research.7169.d115458 — original composite converted to H.264, original 640 × 480 field retained. Mitral scenes show anterior cleft and posterior prolapse before/after repair; it also includes LVOT, LVAD and catheter scenes. Not a normal-valve example.

Video 2: https://doi.org/10.5256/f1000research.7169.d115459 — ICU hypotension case. ME four-chamber excerpt 4.5–8.5 s, concern for biventricular dysfunction; TG midpapillary excerpt 10.5–15.5 s, global LV hypokinesis. H.264 transcodes preserving the complete frame. Not normal examples.

NLM/NIH does not endorse this educational site.

## References opened at the original publication

- Robinson S, Ring L, Augustine DX, et al. The assessment of mitral valve disease: a guideline from the British Society of Echocardiography. 2021. Figure 7. https://pmc.ncbi.nlm.nih.gov/articles/PMC8495880/figure/fig7/ — CC BY-NC-ND 4.0. Linked only; image is not included in this public release.
- Modestini M, Krikken JA, Jansma G, Bouma W, Jainandunsing JS. Aortic Transvalvular Gradient Mis-Quantification. 2025. Video 2b. https://pmc.ncbi.nlm.nih.gov/articles/PMC12324748/ — CC BY-NC-SA 4.0. Linked only; video is not included in this public release.
- SlicerHeart TestingData: https://github.com/SlicerHeart/SlicerHeart/releases/tag/TestingData — dataset-specific redistribution terms have not been confirmed for the mitral/tricuspid samples. Those volumes, contours, derived meshes and the sample MPR page are excluded from the public release. The local private prototype retains them separately.

## Standard views and limitations

ASE/SCA Comprehensive TEE (2013), Table 10: https://www.asecho.org/wp-content/uploads/2014/05/2013_Performing-Comprehensive-TEE.pdf

Toronto Virtual TEE (linked only): https://pie.med.utoronto.ca/TEE/TEE_content/TEE_standardViews_intro_japan.html

The catalog provides all 28 standard views and seven additional vascular views. Nominal angle alone does not identify a leaflet segment: probe depth, rotation, individual anatomy and adjacent planes matter. Whole-heart presets and continuous transitions are approximate model cuts, not validated TEE acquisition trajectories. The grayscale section is not a simulation of ultrasound acoustic properties. The simulator is educational and does not provide diagnostic measurements or guidance for individual patient care.