Category: 5. Suprasternal View of the Aortic Arch

• This view will show the ascending aorta, the aortic arch with its 3 main branches, and the descending aorta. You may see a transverse view of the right pulmonary artery (RPA) as well.

Use color Doppler to assess flow in the thoracic aorta.

• You should see red color Doppler flow (towards probe) in the ascending aorta and blue color Doppler flow (away from probe) in the descending aorta.

• Place the indicator towards the patient’s head.
• Rock the tail of the probe superiorly.
• Then, rotate slightly clockwise (15-20˚) towards the patient’s left shoulder. This allows the ultrasound window to align with the trajectory of the thoracic aorta, which crosses from right-to-left as it arches posteriorly.

The ultrasound Suprasternal Notch View offers a long-axis view of the thoracic aorta including the ascending aorta, the 3 main branches of the aortic arch (the brachiocephalic trunk, left common carotid artery, and left subclavian), and the descending aorta. This view is especially useful when evaluating for a thoracic aortic aneurysm or Type A aortic dissection.

Step 1: Select your Probe.

• Use a Phased Array probe in Cardiac mode. The small footprint of the Phased Array probe allows you to go through the small space of the sternal notch.

Step 2: Position your Patient.

• Your patient should be supine with their neck extended (see below).
• *Placing a pillow under the patient’s shoulders can be helpful.