Transesophageal Echocardiography In-Depth

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What is transesophageal echocardiography? 

Transesophageal echocardiography is a technique that uses a small ultrasound probe placed into a child’s esophagus to closely evaluate the heart and blood vessels within the chest. 

Echocardiography is a procedure used to assess the heart's function and structures through the use of sound waves.

How does transesophageal echocardiography work?

A transducer (similar to a microphone) sends out ultrasonic sound waves at a frequency too high to be heard.

When the transducer is placed on the chest at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves "echo" off of the heart structures.

The transducer picks up the reflected waves and sends them to a computer. The computer interprets the echoes into an image of the heart walls and valves. 

Transesophageal echocardiography (TEE) uses a probe with a transducer on the end that is guided through the throat and into the esophagus while your child is sedated. The TEE transducer works the same as the one used in a regular echocardiogram. A clearer image can be obtained, however, because the sound waves don’t have to pass through skin, muscle or bone tissue.

Why is a transesophageal echocardiogram performed? 

TEE is used to evaluate the internal heart structures and path of blood flow in congenital (present at birth) heart defects.

TEE is often used during heart surgery to evaluate the effects of surgical intervention to the heart, such as repair of congenital heart defects. It also can be used in the Cardiac Catheterization Laboratory to assist with procedures such as a device closure of certain heart defects. 

When an echocardiogram is necessary, but there are other circumstances (such as pulmonary disease) that may interfere with the ability to obtain adequate images, a TEE may be more appropriate.

Also, certain heart conditions, such as mitral valve disease, blood clots or masses inside the heart, dissection (tear) of the lining of the aorta or implanted prosthetic (artificial) heart valves may be better visualized and assessed with TEE than with regular echocardiograms.  TEE is often done to evaluate for blood clots in the heart prior to cardioversion or ablation procedures.

Depending on the results of the TEE, additional tests or procedures may be scheduled to gather further diagnostic information.

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