This test is a specialized imaging technique of echocardiography in which a special flexible probe is placed inside the patient’s esophagus so that we can better visualize the structures of the heart that are not distinguished in detail by conventional echocardiography. Three-dimensional esophageal ultrasound (3D TEE) is now a powerful imaging method used to evaluate both the complex geometry and the dynamic function of the valves and especially the mitral valve (MV).

How is it done?

Prior to the examination you will be asked to sign a consent form for the examination. You should not consume food or fluids for at least 4-6 hours before the test. Some water is allowed. If you wear removable dentures they will be removed so that the tube can pass through safely.

You should tell your cardiologist if you are allergic or have had any reactions to medications, local anesthetics or latex. You should also tell your doctor if you are taking anticoagulants because you may be asked to stop taking them for a while before the test.

You will then lie down on the examination bed and connect to the electrocardiogram, oxygen saturation and blood pressure monitor so that can be monitored throughout the test. An intravenous catheter will be placed in your hand so that we can administer the mild sedative to relax and administer intravenous fluids if needed.

After applying a local anesthetic spray (xylocaine) to the back of your neck so that the passage of the probe is more comfortable, a bite protector will be placed in your mouth and an attempt will be made to pass the probe through your mouth. You may be asked to swallow to help pass the tube.

Once the images are obtained the probe will be removed and you will be able to move when your vital signs are stable, the sedative effect has passed and the swallowing reflex has returned.

Possible complications of TEE are

• Respiratory problems especially in patients with underlying diseases such as chronic obstructive pulmonary disease.
• Injury to the teeth, mouth, throat or esophagus. If you have known esophageal problems, you may not be able to get tested.

Where is it used?

• In cases of patients where the transthoracic echocardiogram is not diagnostic or reliable findings are not expected due to the patient’s condition (overweight or lung disease).
• In patients who need a detailed study of structures that are far from the surface of the chest such as the aorta.
• In patients with mitral valve disorders for better assessment.
• In patients with prosthetic metallic valves.
• In patients with a possible diagnosis of endocarditis to exclude the presence of possible valve failure or paravalvular abscess.
• Patients on ventilators or chest injuries or sternal skin disorders that require cardiac imaging.
• The intraoperative TOE is a very helpful tool during a valve repair or replacement surgery.
• During the invasive procedure of the Atrial Septal Defect (ASD) repair.
• In patients with atrial fibrillation or atrial flutter to rule out thrombosis for possible cardioversion.

Please contact us in case you need personalized detailed clarifications. This examination, if required, is carried out in a different space with the appropriate diagnostic infrastructure.