Transesophageal echocardiogram
A transesophageal echocardiogram, or TEE (TOE in the United Kingdom and other countries such as Australia and New Zealand, reflecting the British English spelling transoesophageal), is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus.[1] This allows image and Doppler evaluation which can be recorded. It is commonly used during cardiac surgery and is an excellent modality for assessing the aorta, although there are some limitations.[2]
It has several advantages and some disadvantages compared with a transthoracic echocardiogram (TTE).
Clinical uses[edit]
In addition to use by cardiologists in outpatient and inpatient settings, TEE can be performed by a cardiac anesthesiologist to evaluate, diagnose, and treat patients in the perioperative period. Most commonly used during open heart procedures, if the patient's status warrants it, TEE can be used in the setting of any operation. TEE is very useful during many cardiac surgical procedures (e.g., mitral valve repair). It is actually an essential monitoring tool during this procedure. It helps to detect and quantify the disease preoperatively as well as to assess the results of surgery immediately after the procedure. If the repair is found to be inadequate, showing significant residual regurgitation, the surgeon can decide whether to go back to cardiopulmonary bypass to try to correct the defect. Aortic dissections are another important condition where TEE is very helpful. TEE can also help the surgeon during the insertion of a catheter for retrograde cardioplegia.
0° four chamber
45° aortic valve short-axis
90° two chamber
135° aortic valve long-axis
History[edit]
The transesophageal echocardiogram was first invented by Dr. Leon Frazin in 1974 while working at the Loyola University Stritch School of Medicine, Maywood, and Veterans Administration Hospital, Hines, Illinois. His early findings were published in 1976 in Circulation [9]
While TEE can be used to answer many questions that a transthoracic echo can answer, the TEE is used for some diseases in particular.