Transesophageal echocardiography is done by inserting a probe down your throat (esophagus) to the level of the heart. The TEE transducer works the same as the transducer used for the other procedures. However, a clearer image can be obtained, because the sound waves do not have to pass through skin, muscle, or bone tissue. Certain conditions of the heart, such as mitral valve disease, blood clots or masses inside the left atrium, dissection (tear) of the lining of the aorta (the artery which carries oxygenated blood from the heart to the body), and implanted prosthetic (artificial) heart valves are better visualized and assessed with TEE.
TEE may also be used during surgery to assess the cardiac status of patients with known cardiac disease who are undergoing noncardiac procedures, and during heart surgery to evaluate the effects of surgical intervention to the heart, such as bypass surgery or valve repair or replacement.
For a TEE procedure, you are taken to a special area with echocardiography and EKG equipment. You will undress from the waist up, and EKG pads will be attached to your chest. You will be given a gown to wear. You will lie on a table or bed for the procedure. An intravenous (IV) line is placed in your hand or arm, so that sedative medication can be given. Sedatives are given to help you relax, but you will remain awake enough to assist in the procedure by swallowing as the TEE probe is passed down your throat. A numbing medication will be sprayed in the back of your throat to make passage of the TEE probe more comfortable. If you have an artificial heart valve, certain congenital conditions, or a history of endocarditis (infection of heart valves), you may be given a dose of IV antibiotics an hour or so prior to the procedure. The echo images are obtained from various angles, as the physician can position the TEE probe remotely. Once all the necessary images have been obtained, the TEE probe will be removed from your throat. You will continue to be monitored in a recovery area until your gag reflex returns and you can swallow adequately enough to take fluids without choking and until you are alert enough to leave. Your heart rate, EKG, blood pressure, and breathing rate will be monitored. Your oxygen level may also be monitored by a probe placed on the tip of a finger or ear lobe. You will need to make arrangements for someone to drive you home after the procedure, as you will not be allowed to drive after having IV sedation.
A TEE usually takes about 2 hours to perform. However, the length of the procedure can be affected by factors such as schedule delays, emergencies, and other factors which may delay the start of your procedure or prolong the length of it.