From the Guidelines
Transesophageal Echocardiography (TEE) can obtain a wide range of values and measurements, including left ventricular ejection fraction, chamber dimensions, wall thickness, and regional wall motion abnormalities, as well as accurately measure valve areas, gradients, and regurgitation severity. TEE provides detailed measurements and values of cardiac structure and function that are superior to transthoracic echocardiography in many cases 1. The values and measurements that can be obtained from TEE include:
- Left ventricular ejection fraction
- Chamber dimensions
- Wall thickness
- Regional wall motion abnormalities
- Valve areas, gradients, and regurgitation severity, including mitral valve area, aortic valve area, and regurgitant volumes
- Left atrial dimensions and detection of thrombi
- Detailed imaging of the aorta, including identification of dissections, aneurysms, and atherosclerotic plaques
- Right ventricular function
- Pulmonary artery pressures
- Detection of intracardiac shunts through color Doppler and bubble studies
- Assessment of systemic and pulmonary venous connections
- Evaluation of atrial baffle function and Fontan anatomy
- Guidance of closure of atrial level shunts and other interventional procedures
TEE is especially useful for assessing the intrathoracic aorta, native and prosthetic valves, and ventricular function; detecting atrial level shunts; diagnosing and managing endocarditis and its complications; and identifying cardiac sources of emboli 1. The use of TEE has been shown to provide new or altered diagnoses and new information in adults with congenital heart disease, including identification of the atrial appendages and atrial septum, delineation of systemic and pulmonary venous connections, and improved morphologic assessment of the atrioventricular junction and valves 1. TEE is a valuable tool for obtaining detailed measurements and values of cardiac structure and function, and its use is essential in the assessment and management of congenital heart disease.
From the Research
Values and Measurements Obtained from Transesophageal Echocardiography (TEE)
The following values and measurements can be obtained from TEE:
- Left ventricular (LV) function, including systolic and diastolic function, preload, and afterload 2
- Ejection fraction (EF) to assess systolic function 2, 3
- Transmitral flow (TMF) and pulmonary vein flow patterns to assess diastolic function 2, 4
- Mitral annular velocity and color M-mode TMF propagation velocity (Vp) to assess diastolic function 2
- LV dP/dt to assess systolic function 2
- Myocardial performance index (Tei index) to assess both systolic and diastolic functions, as well as right ventricular function 2
- LV volumetry, wall motion, dyssynchrony, and valvular pathology using real-time 3-dimensional systems 2
- Pulmonary artery systolic pressure from tricuspid regurgitation 4
- Left-atrial pressure and left-ventricular filling pressure using continuous-wave Doppler echocardiography and tissue Doppler imaging 4
- Cardiac output and ventricular ejection fraction 4
- Detection of myocardial ischemia in patients with coronary artery disease undergoing noncardiac surgery 5
- Assessment of the results of valvular surgery 5
Additional Measurements
TEE can also provide information on: