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Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to t

CPT4 code

Name of the Procedure:

Echocardiography, Transesophageal (TEE) for Monitoring Purposes

Summary

Transesophageal Echocardiography (TEE) is a diagnostic procedure that involves inserting a flexible tube with an ultrasound probe down the esophagus to capture detailed images of the heart. It provides real-time, 2-dimensional images for continuous assessment of cardiac function, especially during dynamic changes.

Purpose

TEE is used to monitor heart function accurately and continuously, especially in settings like surgery or intensive care. It helps detect abnormalities in the heart's structure and function, guiding treatment decisions in real time.

Indications

  • Unexplained chest pain
  • Suspected heart valve disorders
  • Need for precise cardiac monitoring during heart surgery
  • Assessing heart function in critically ill patients
  • Diagnosing congenital heart defects

Preparation

  • Patients are usually required to fast for at least 6 hours before the procedure.
  • Medication adjustments may be necessary; specific instructions will be provided by the healthcare team.
  • Pre-procedure tests may include blood work and standard echocardiograms.

Procedure Description

  1. The patient is given a sedative and a local anesthetic to numb the throat.
  2. A flexible probe with a transducer at the tip is gently inserted through the mouth into the esophagus.
  3. Real-time images of the heart are captured and interpreted continuously by a cardiologist.
  4. The procedure allows for ongoing assessment of the heart’s pumping function and other dynamics.

Duration

The entire procedure usually takes about 30 to 60 minutes.

Setting

TEE is typically performed in a hospital setting, either in the echocardiography lab, operating room, or intensive care unit.

Personnel

  • Cardiologist (usually performs the procedure)
  • Anesthesiologist or nurse anesthetist (administers sedation)
  • Echocardiography technician (may assist with the equipment)
  • Nurses (provide care before, during, and after the procedure)

Risks and Complications

  • Sore throat or discomfort from the probe (common)
  • Reaction to sedation
  • Risk of esophageal or throat injury (rare)
  • Temporary hoarseness
  • Risk of infection

Benefits

  • Provides highly detailed and accurate images of the heart.
  • Allows for continuous monitoring of heart function.
  • Helps in the accurate diagnosis and management of cardiac conditions.
  • Real-time data that can influence immediate clinical decisions, leading to better outcomes.

Recovery

  • Patients are monitored post-procedure until the sedation wears off.
  • Sore throat and mild discomfort are common but usually resolve within a day.
  • Normal activities can generally be resumed within 24 hours.
  • Follow-up instructions will be provided, and any necessary subsequent appointments will be scheduled.

Alternatives

  • Transthoracic Echocardiography (TTE): Non-invasive but less detailed images.
  • Cardiac MRI or CT: Non-invasive but not real-time and more costly.
  • Each alternative varies in terms of detail, invasiveness, and real-time capability.

Patient Experience

  • Mild discomfort or gagging sensation during probe insertion.
  • Sedation helps in providing comfort and reducing anxiety.
  • Post-procedure sore throat is common, but pain management measures will be provided. Recovery is generally quick, with minimal long-term effects.

Medical Policies and Guidelines for Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to t

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