Transoesophageal echocardiography, TEE (transoesophageal-echo)

What is a transoesophageal echocardiography?

In the case of a transoesophageal echocardiography, the heart and the adjoining vessels are examined out from the oesophagus by means of ultrasound. Since the oesophagus passes directly behind the heart, this disposes of all interference factors such as the lung tissue, ribs, muscle and adipose tissue, and the skin.

When is a transoesophageal echocardiography necessary?

Transoesophageal echocardiography is necessary when the doctor obtains no accurate picture from the usual ultrasound examination of the heart from the outside through the chest wall, and can therefore make no adequate diagnosis. This is carried out particularly if the doctor needs information on malignant changes of the aorta (aortal dissection, aortal aneurysm) or changes in the heart valves (such as inflammations – “Endocarditis”). He can also use this method to search for possible sources of embolisms, for instance if the patient has suffered a stroke, and the cause has not yet been identified. This is practically the only method of showing thrombi (blood clots) in the left atrium or atrial appendage.

With the aid of contrast agents injected into the vein, possible openings (“shunts”) in the atrium and septum wall can also be discovered where blood clots could pass through and cause a stroke. This type of examination can also identify tumours, and in patients who have undergone operations for congenital heart defects or have had a “shield” implanted, the position of the shield can be checked during the course of the TEE.

Procedure

A flexible probe (“echoscope”) with a small built-in ultrasonic transmitter is introduced into the patient’s oesophagus. Local anaesthesia is applied to the wall of the throat before the examination in the form of a spray. At the request of the patient, a sedative injection may also be administered. This examination is tolerated perfectly well by most patients.

The examination is carried out at our practice on an out-patient basis.

Duration

The transoesophageal echocardiography takes about 15 minutes.

Risks

The examination involves a very low risk.

Note

The patient should not eat or drink anything for six hours before the examination.

If the patient is given a sedative injection, he should not operate a motor vehicle or any other machinery for the following 24 hours.