Transesophageal Echocardiography (TEE) – A Detailed Overview

Introduction

Transesophageal Echocardiography (TEE) is an advanced ultrasound technique used in cardiology to obtain detailed images of the heart and its structures. Compared to transthoracic echocardiography (TTE), TEE provides much clearer and more detailed images due to its ability to bypass interference from the lungs and chest wall.

Why is TEE Performed?

TEE is used to diagnose and assess several heart conditions, including: - Valvular heart disease – Identifying valve dysfunction, stenosis, or regurgitation. - Endocarditis – Detecting vegetations or infections on heart valves. - Aortic diseases – Evaluating aortic dissection or aneurysms. - Congenital heart defects – Diagnosing structural abnormalities in the heart. - Stroke evaluation – Identifying possible sources of embolism (such as atrial septal defects or left atrial thrombi). - During cardiac surgery or catheter-based procedures – Providing real-time guidance for interventions.

How is TEE Performed?

  1. Preparation: Patient fasts for 6 to 8 hours before the test.
  2. Sedation: Mild sedation is given to ensure comfort.
  3. Probe Insertion: A flexible probe with an ultrasound transducer is inserted into the esophagus via the mouth.
  4. Imaging: The sonographer captures high-resolution images of the heart.
  5. Recovery: The patient is monitored until sedation wears off.

Risks and Considerations

Although TEE is generally safe, some risks include: - Mild throat discomfort after the procedure. - Rare complications like esophageal injury or aspiration in high-risk patients. - Arrhythmias or hemodynamic instability in critically ill patients.

Conclusion

TEE is a highly valuable diagnostic tool, often utilized when standard transthoracic echocardiography does not provide sufficient detail. It plays a crucial role in diagnosing and managing complex cardiovascular diseases.

Source recommendations

1. American Society of Echocardiography Guidelines

  1. https://www.asecho.org/guidelines-search/
  2. https://pubmed.ncbi.nlm.nih.gov/30282592/
  3. https://www.asecho.org/wp-content/uploads/2018/10/Guidelines-for-Performing-a-Comprehensive-Transthoracic-Echocardiographic-Examination-in-Adults.pdf
  4. https://www.onlinejase.com/content/aseguidelines
  5. https://asecho.org/wp-content/uploads/2016/03/2016_LVDiastolicFunction.pdf

2. European Association of Cardiovascular Imaging Guidelines

  1. https://www.escardio.org/Guidelines/Scientific-Documents/Recommendations-and-position-papers
  2. https://academic.oup.com/ehjcimaging/article/16/1/12/2403250
  3. https://www.escardio.org/Sub-specialty-communities/European-Association-of-Cardiovascular-Imaging-(EACVI)
  4. https://academic.oup.com/ehjcimaging/article/20/12/1321/5572609
  5. https://pubmed.ncbi.nlm.nih.gov/29045589/

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