Transesophageal Echocardiogram

TEE is a specialized type of cardiac exam where physicians obtain ultrasound images of the heart from a transducer positioned in the esophagus behind the heart. The transducer is a small device mounted on the tip of a gastroscope. It sends and receives sound waves reflected back from the heart. These reflected sound waves are processed by a special computer that displays an image of the heart on a video monitor.

TEE provides very high quality images of the heart that are unobtainable from a traditional echocardiography exam where the transducer is placed on the chest. Because the back of the heart is very close to the transducer during the procedure and because there is no bone or lung interference, the highly detailed images produced have great diagnostic value.

Your physician may want you to undergo a TEE exam for a wide variety of reasons. Frequently it is prescribed for patients who are difficult to image through the conventional method of placing a transducer on the chest. It is also used to gather information about patients with congenital heart disease, patients with replaced heart valves, and patients suspected of having blood clots in the left side of the heart. TEE is also used for patients who are candidates for open heart surgery, where repair or replacement of a valve is being considered.

The TEE transducer is much smaller than the transducer used on your chest during a standard echocardiography exam and is no wider than a normal-size piece of food you might swallow. Since you may experience some discomfort when the probe is inserted, your doctor will probably anesthetize the back of your throat. Once the transducer is inserted into your esophagus, you should feel very little discomfort.

Your outpatient TEE exam will be performed by a physician trained in the procedure. The procedure will last approximately one hour; however, the probe is inserted generally for only 10 to 15 minutes. During the exam your heart rate and blood pressure will be monitored continuously.

You'll be asked to remove dentures or any oral prosthesis you have as well as to gargle with a liquid to anesthetize the back of your throat. A mild sedative will be given to you intravenously. In some cases a medication will be given to minimize the amount of saliva you produce. You'll then be asked to lie comfortably on your side while the probe is inserted. While the probe is in your esophagus, a suction device just like the one your dentist normally uses may be placed in your mouth to remove saliva. Once the exam is completed, the probe will be gently removed.

You will probably feel numbness in the back of your throat. You should not eat or drink anything for a minimum of one hour or until the numb feeling subsides. You must bring a friend or relative with you so they can drive you home after the procedure is completed. You will not be allowed to drive for a 24 hour period following the exam.

PREPARATION

-You should not eat or drink anything for twelve (12) hours prior to the procedure.

Medications that must be taken can be swallowed with a small sip of water at

normally scheduled time.

-You will receive a mild sedative for the procedure. Therefore, you must bring a friend

or relative with you so that they can drive you home after the procedure is completed.

You will not be allowed to drive for a 24 hour period following the exam.