Advertisement

Transesophageal Echocardiography

  • Azin Alizadehasl
  • Anita Sadeghpour
  • Fahimeh Khesali
Chapter

Abstract

Transesophageal echocardiography (TEE) has a key role in evaluation of mitral valve lesions, the left atrium or its appendage, atrial septal defects, intracardiac masses, endocarditis and its complications, and thoracic aortic lesions such as aortic dissection. Patients with atrial fibrillation undergo direct-current cardioversion without chronic anticoagulation if TEE does not show intracardiac thrombi. With ablation procedures, atrial fibrillation has become one of the most common reasons for TEE referrals. The crucial role of TEE in the operating room and the cath lab for the assessment of the result of various valvular repair, and interventional procedures has been proved.

In this chapter, we will review the indications and contraindications of TEE as well as its standard views and necessary preparations.

Keywords

Transthoracic echocardiography Standard windows Echocardiographic views Valvular heart disease Interventional TEE Intraoperative TEE 

Abbreviations

AV

Aortic valve

IAS

Inter-atrial septum

IE

Infective endocarditis

IVC

Inferior vena cava

IVS

Inter-ventricular septum

LA

Left atrium

LAA

Left atrial appendage

LLPV

Left lower pulmonary vein

LUPV

Left upper pulmonary vein

LV

Left ventricle

LVOT

Left ventrivular outflow tract

MV

Mitral valve

MVLs

Mitral valve leaflets

P

Posterior

RA

Right atrium

RLPV

Right lower pulmonary vein

RUPV

Right upper pulmonary vein

RV

Right ventricle

RVOT

Right ventricular outflow tract

SVC

Superior vena cava

TEE

Transesophageal echocardiography

TTE

Transthoracic Echocardiography

TVLs

Tricuspid valve leaflets

References

  1. 1.
    Hahn RT, Abraham T, Adams MS, Bruce CJ, Glas KE, Lang RM, Reeves ST, Shanewise JS, Siu SC, Stewart W, Picard MH. Guidelines for Performing a Comprehensive Transesophageal Echocardiographic Examination: Recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. ASE GUIDELINES AND STANDARDS. J Am Soc Echocardiogr. 2013;26:921–64.CrossRefGoogle Scholar
  2. 2.
    Min JK, Spencer I, Furlong KT, et al. Clinical features of complications from transesophageal echocardiography: a single-center case series of 10,000 consecutive examinations. J Am Soc Echocardiogr. 2005;18:925–9.CrossRefGoogle Scholar
  3. 3.
    Novaro GM, Aronow HD, Militello MA, et al. Benzocaine-induced methemoglobinemia: experience from a high-volume transesophageal echocardiography laboratory. J Am Soc Echocardiogr. 2003;16:170–5.CrossRefGoogle Scholar
  4. 4.
    Brinkman WI, Shanewise JS, Clements SO, et al. Transesophageal echocardiography: not an innocuous procedure. Ann Thorac Surg. 2001;72:1725–6.CrossRefGoogle Scholar
  5. 5.
    Steckelberg JM, Khandheria BK, Anhalt P, et al. Prospective evaluation of the risk of bacteremia associated with transesophageal echocardiography. Circulation. 1991;84:177–80.CrossRefGoogle Scholar
  6. 6.
    Hahn RT, Abraham T, Adams MS, Bruce CJ, Glas KE, Lang BM, et al. Guidelines for Performing a Comprehensive Transesophageal Echocardiographic examination: Recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2013;26:921–64.CrossRefGoogle Scholar
  7. 7.
    American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, et al. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 appropriate use criteria for echocardiography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians. J Am Soc Echocardiogr. 2011;24:229–67.CrossRefGoogle Scholar
  8. 8.
    American College of Cardiology Foundation Appropriate Use Criteria Task Force, Hendel RC, Patel MR, Allen JM, Min JK, Shaw LJ, et al. Appropriate use of cardiovascular technology: 2013 ACCF appropriate use criteria methodology update. J Am Coll Cardiol. 2013;61:1305–17.CrossRefGoogle Scholar
  9. 9.
    Intersocietal Accrediation Commission. IAC standards for adult echocardiography accreditation. http://www.intersocietal.org/echo/standards/IACAdultEchocardiographyStandards2012.pdf. Accessed 27 Jul 2013.
  10. 10.
    Skiles JA, Griffin BP. Transesophageal echocardiographic (TEE) valuation of ventricular function. Cardiol Clin. 2000;18:681–97.CrossRefGoogle Scholar
  11. 11.
    Flachskampf FA, Badano L, Daniel WG, Feneck RO, Fox KF, Fraser AG, et al. Recommendations for transoesophageal echocardiography: update. Eur J Echocardiogr. 2010;11:557–76.CrossRefGoogle Scholar
  12. 12.
    Zamorano JL, Badano LP, Bruce C, Chan KL, Goncalves A, Hahn RT, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. J Am Soc Echocardiogr. 2011;24:937–65.CrossRefGoogle Scholar
  13. 13.
    Hahn R, Abraham T, Adams M, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2013;9:921–64.CrossRefGoogle Scholar
  14. 14.
    Evangelista A, Flachskampf FA, Erbel R, et al. European Association of Echocardiography; Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur J Echocardiogr. 2010;8:645–58.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Azin Alizadehasl
    • 1
  • Anita Sadeghpour
    • 2
  • Fahimeh Khesali
    • 2
  1. 1.Echocardiologist, Echocardiography and Cardiogenetic Research CentersCardio-Oncology Department, Rajaie Cardiovascular Medical and Research CenterTehranIran
  2. 2.Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran

Personalised recommendations