Transthoracic and Transesophageal Echocardiography
Echocardiography helps to determine cardiac function( contractile power, Ejection fraction), diagnose valvular heart disease, congenital heart disease, shunts- cardiac and between major vessels, anatomy and dimension of major vessels( aorta and pulmonary artery), aortic dissection flap, pulmonary embolism( right heart dilatation), pulmonary hypertension and certain causes, previous heart attack, coronary artery disease( segmental wall motion abnormality), complications after heart attack( valvular insufficiencies, chordae rupture, pericardial effusion etc).
What is Transesophageal Echocardiography(TEE)?
TEE is an endoscopic procedure in which an echocardiographic probe is inserted through the esophagus which lies just behind the left atrium and acquires high resolution images compared to Transthoracic Echocardiography. So it is used whenever transthoracic echocardiography is not enough to give the detailed information needed for diagnosis or management.
When is TEE indicated?
TEE is used to investigate the presence of thrombus or mass in stroke patient, vegetation and valvular complications in infective endocarditis, calculate the function of the prosthetic valves, diagnosis of aortic dissection, presence of shunt( ASD, VSD, PFO), used intraoperatively to determine the efficacy of surgery. It is also used to diagnose congenital heart disease and as a guidance in the treatment of structural heart disease treatment like PFO Closure, ASD Closure, VSD Closure, Appendix Closure, Paravalvular Leak Closure, Mitraclip, Tricuspid clip etc.
Frequently asked questions about transesophageal
echocardiography.
What is Transesophageal Echocardiography? How long does the
procedure take?
Whenever imaging of the heart with transthoracic echocardiography is not enough, transesophageal echocardiography is used. A TEE probe is inserted through the mouth to the esophagus and the imaging of the heart is done from mid esophagus, lower esophagus and transgastric. The procedure, alongwith the patient preparation takes about half an hour.
What are the preparations for TEE?
Patients should have a fasting period of at least 6 hours and the drugs should be discussed with the doctor. The prosthesis inside the mouth should be taken out and the patient should inform the doctor if he/she has difficulty in swallowing,
esophageal diseases, allergy and asthma, history of disease or operation of the stomach in the past. An iv line is a must before the procedure. Procedure is either done under sedation or without sedation in cooperative patients.
What should be done after the procedure?
After the procedure the patient should not eat or drink for two hours. If the procedure was done under sedation, driving is strictly prohibited for 2 hours.