Transesophageal echocardiography (TEE)

Study of the heart with two-dimensional M-mode or Doppler echocardiography.

Done from within the esophagus to improve the penetration of sound and avoiding the lungs and ribs.

Results in excellent resolution of cardiac structures.

The transducer is placed in the esophagus via an endoscope.

Patients are monitored for blood pressure, cardiac rate, rhythm and respiratory status as excessive sedation, aspiration or esophageal damage can occur with this study.

Most common indications are for infectious endocarditis, assessment for embolic risk prior to cardioversion for atrial fibrillation, evaluation of the heart and aorta as a source of systemic embolism, assessment for aortic dissection, intraoperative and perioperative cardiac monitoring and when transthoracic echocardiography is not adequate such as with the presence of a mechanical ventilator.

Detects thrombi in the left atrial appendage with a high degree of accuracy.

Transesophageal echo cardiography remains of the very imaging tool for endocarditis with the sensitivity between 90 and 92%.

Transesophageal echocardio graph is more invasive and requires minimum conscious sedation, and in some cases general anesthesia.

Sensitivity to detect vegetations on native valves in infectious endocarditis is 90-100% compared to 60% for transthoracic echocardiography.

Sensitivity to detection of infectious endocarditis in patients with prosthetic valve disease is 85% compared to 36% detection rate for transthoracic echocardiography.

Superior to transthoracic echocardiography in evaluation of the pulmonary and tricuspid valves and in inspecting a prosthetic valve.

Provides better images in patients with severe kyphosis, obesity and lung disease than does transthoracic echocardiography.

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