Name of the Procedure:

Transesophageal Echocardiography (TEE) with Contrast, or without Contrast followed by with Contrast, Real-Time with Image Documentation (2D) (with or without M-mode Recording); including Probe Placement, Image Acquisition, Interpretation, and Report (C8925).

Summary

Transesophageal echocardiography (TEE) is a diagnostic test that uses sound waves to create detailed images of the heart. A special probe is guided down the esophagus to get a closer view of the heart without the interference of the ribs or lungs. The test can be performed with or without contrast to provide clearer images.

Purpose

TEE is used to diagnose and assess various heart conditions, such as heart valve diseases, congenital heart defects, and blood clots in the heart. The goal is to provide detailed images to help doctors make informed decisions regarding treatment.

Indications

• Symptoms of heart valve disease (e.g., shortness of breath, fatigue).
• Unexplained chest pain or stroke-like symptoms.
• Atrial or ventricular septal defects.
• Infections of the heart (endocarditis).

Preparation

• Fasting for at least 6 hours before the procedure.
• Adjustments to regular medications as advised by the physician.
• Pre-procedure blood tests or other diagnostic assessments as needed.

Procedure Description

1. The patient is given a mild sedative to help them relax.
2. A numbing agent is sprayed into the throat.
3. A thin, flexible probe is guided down the esophagus to the heart.
4. The probe emits sound waves that create real-time images of the heart.
5. If needed, a contrast agent is injected to enhance image clarity.
6. The images are documented, and the probe is carefully removed.
7. A cardiologist interprets the images and prepares a report.

Tools & Equipment:

• TEE probe
• Ultrasound machine
• Contrast agent (if used)
• Sedative medications

Anesthesia & Sedation:

• Local anesthesia for throat numbing.
• Mild sedation to ensure patient comfort.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is generally performed in a hospital or an outpatient clinic with appropriate facilities.

Personnel

• Cardiologist (performs and interprets the test)
• Nurse (assists with patient care and sedation)
• Ultrasound technician (operates ultrasound equipment)

Risks and Complications

• Sore throat or minor discomfort in the esophagus.
• Rare risks include esophageal injury, bleeding, or reaction to the contrast agent.
• Complications are typically managed with medication or simple interventions.

Benefits

• Provides detailed, real-time images of the heart.
• Helps diagnose complex heart conditions accurately.
• Can potentially prevent invasive surgery by providing sufficient information.

Recovery

• Observation period of about 1-2 hours post-procedure.
• Avoid eating or drinking until the throat numbness wears off.
• Restriction from driving or operating heavy machinery for the rest of the day due to sedation.

Alternatives

• Transthoracic echocardiography (TTE): A less invasive procedure but may provide less detailed images.
• Cardiac MRI or CT scan: Non-invasive options that provide detailed images but may require a different diagnostic timeline.

Patient Experience

During the procedure, the patient might feel mild discomfort or pressure in the throat and chest. Post-procedure, there may be temporary soreness in the throat. Pain management includes mild pain relievers and throat lozenges, with overall discomfort dissipating within a day.