Transesophageal Echocardiogram What To Look For

A transesophageal echocardiogram (TEE) is a specialized imaging procedure used to evaluate the structure and function of the heart. It is particularly useful when a clearer view of the heart is needed than what can be obtained through a standard transthoracic echocardiogram (TTE). This procedure involves inserting a small ultrasound probe into the esophagus, allowing for high-resolution images of the heart's chambers, valves, and surrounding structures.

Common Indications for TEE

Evaluating Complex Cardiac Structures: TEE is especially valuable in cases where the quality of imaging through the chest wall is limited. It is the preferred method for assessing conditions such as prosthetic valve dysfunction (including stenosis or paravalvular leak), abnormalities of the left and right atrial appendages (such as thrombi), and valvular vegetations (on the aortic, mitral, tricuspid, and pulmonary valves). It also plays a critical role in diagnosing pathologies like aortic dissection, atrial septal defects, patent foramen ovale, and anomalies of the coronary arteries.

Pre-Procedure Assessment for Atrial Fibrillation Patients

Left Atrial Appendage Thrombus Detection: For patients with atrial fibrillation undergoing radiofrequency ablation, TEE is routinely used to rule out the presence of a left atrial appendage clot. Additionally, for individuals considering left atrial appendage closure, TEE is essential for pre-procedural evaluation of the appendage's anatomy, including size and shape measurements. During the procedure, TEE helps guide the placement of the closure device and assesses pulmonary vein flow to ensure optimal outcomes.

Role in Cardiac Surgery

Intraoperative Monitoring: TEE is indispensable in cardiac surgery, particularly for procedures involving left ventricular outflow tract obstruction relief, valve repair or replacement, and managing unexpected intraoperative complications. Real-time monitoring with TEE allows surgeons to assess the immediate results of the intervention and make necessary adjustments during the operation, improving patient outcomes and safety.