Transesophageal echocardiography (TEE) at CMC Dubai

Transesophageal echocardiography (TEE) is a diagnostic procedure that involves the insertion of a specialized ultrasound probe into the esophagus to obtain detailed images of the heart. TEE provides a closer and clearer view of the heart structures compared to a standard transthoracic echocardiogram (TTE). It is primarily used for diagnosis but can also aid in treatment planning. Here’s an overview of the diagnosis and treatment aspects of transesophageal echocardiography:

Diagnosis:

1. Valvular heart disease: TEE is particularly useful for evaluating valvular heart disease, such as mitral valve abnormalities (e.g., mitral regurgitation or stenosis) and aortic valve disorders (e.g., aortic regurgitation or stenosis). It provides detailed images of the valve structures, allowing for accurate assessment of valve function, size, and potential abnormalities.
2. Cardiac source of embolism: TEE is commonly employed to identify a cardiac source of embolism, which refers to blood clots or debris originating from the heart that can lead to stroke or peripheral arterial occlusion. The procedure can visualize potential sources, such as atrial or ventricular thrombi, and assess their size, location, and mobility.
3. Infective endocarditis: TEE is considered the gold standard for diagnosing infective endocarditis, an infection of the heart valves or inner lining of the heart chambers. It can detect characteristic findings such as vegetation, abscesses, or valve perforations that may not be readily visualized by other imaging techniques.
4. Aortic diseases: TEE is useful for diagnosing aortic diseases such as aortic dissection or aortic aneurysm. It provides detailed images of the aorta, allowing for accurate assessment of the location, extent, and severity of these conditions.

Treatment:

1. Treatment planning: TEE plays a crucial role in treatment planning for various cardiac conditions. The detailed images obtained during the procedure help guide decisions regarding the appropriate treatment approach, such as surgical intervention, transcatheter procedures, or medical management.
2. Intraoperative monitoring: TEE can be utilized during cardiac surgeries or interventions to monitor real-time changes in heart structure and function. It provides immediate feedback to the surgical team, assisting in the placement and evaluation of prosthetic valves, detection of residual leaks, or assessment of myocardial function.
3. Follow-up assessment: After undergoing treatment or intervention, TEE can be used to assess the effectiveness of the procedure and evaluate post-procedural complications. It provides valuable information on the outcomes of interventions and helps guide further management decisions.
4. Prognosis evaluation: TEE findings, such as the severity of valve disease, presence of thrombi, or extent of aortic disease, can provide prognostic information. They assist healthcare professionals in determining the patient’s future risk and developing appropriate long-term management strategies.

TEE is performed by a trained healthcare professional, typically a cardiologist or a specialized echocardiographer. It requires sedation or anesthesia to minimize discomfort during the procedure. The images obtained are interpreted by the healthcare professional, who considers the patient’s clinical history, symptoms, and other diagnostic tests to provide a comprehensive diagnosis and treatment plan.

It’s important to note that TEE is an invasive procedure and is typically reserved for cases where more detailed information is needed beyond what a standard transthoracic echocardiogram can provide. The decision to perform TEE should be made by the healthcare professional based on the patient’s individual circumstances and clinical indications.