From the Guidelines
The primary purpose of a Transesophageal Echocardiogram (TEE) is to obtain detailed images of the heart and its structures, particularly when evaluating structures that are difficult to visualize through the chest wall, and it is commonly used to detect blood clots, assess valve function, diagnose infections, and guide cardiac procedures 1.
Common Uses of TEE
The following are some of the common uses of TEE:
- Evaluation of suspected acute aortic pathology, including dissection or transsection 1
- Guidance during percutaneous noncoronary cardiac interventions, such as septal ablation or mitral valvuloplasty 1
- Determining the mechanism of regurgitation and suitability of valve repair 1
- Diagnosing and managing endocarditis with a moderate or high pre-test probability 1
- Evaluating patients with atrial fibrillation or flutter to facilitate clinical decision-making regarding anticoagulation, cardioversion, or radiofrequency ablation 1
Procedure and Benefits
TEE is a minimally invasive procedure that provides superior image quality compared to transthoracic echocardiography due to the proximity of the ultrasound probe to the heart in the esophagus 1. The procedure typically takes 30-60 minutes and is performed under mild sedation to minimize discomfort. Patients must fast for 6-8 hours before the procedure to reduce the risk of aspiration.
Clinical Applications
TEE has a wide range of clinical applications, including detection and assessment of endocarditis, aortic dissection, intracardiac thrombi, and valvular disorders 1. It is also useful in patients with suspected cardiac trauma, critically ill patients with unstable hemodynamics, and patients whose clinical status necessitates echocardiographic assessment but in whom TTE studies are technically inadequate or non-diagnostic 1.
From the Research
Purpose of TEE
The purpose of a Transesophageal Echocardiogram (TEE) is to provide high-resolution images of the heart and its structures without interference from lung and bone, allowing for the diagnosis of various cardiac and vascular conditions.
Key Indications for TEE
- Diagnosis of thoracic aortic disease, including aortic dissection, aneurysm, and intraaortic thrombus 2
- Assessment of left atrial masses, atrial septal defects, mitral valve disease, valvular prostheses, and aortic dissection 3
- Detection of early myocardial ischemia in patients with coronary artery disease undergoing noncardiac surgery 3
- Evaluation of the results of valvular surgery 3
- Identification of candidates for mitral valve repair and checking intraoperatively the results of surgery 4
Benefits of TEE
- Provides detailed information about cardiac structure and function 5
- Allows for high spatial resolution and access to structures that are not well seen by transthoracic echocardiography 4
- Can be performed at the patient's bedside or in the operating suite 2
- Relatively safe and noninvasive, with a low risk of complications 6