Name of the Procedure:

Common Name(s): Transesophageal Echocardiography (TEE) Technical/Medical Terms: TEE with contrast, TEE without contrast, TEE for congenital cardiac anomalies, C8926

Summary

Transesophageal Echocardiography (TEE) is a diagnostic test that uses sound waves to create detailed images of the heart. Unlike the standard echocardiogram, this procedure involves inserting a specialized probe down the esophagus to get closer to the heart, for clearer and more accurate images. The procedure can be performed with or without contrast dye to enhance the images, especially for detecting congenital cardiac anomalies.

Purpose

TEE is used to diagnose and evaluate congenital cardiac anomalies (structural heart defects present from birth). It aims to provide highly detailed images to assess the heart's structure and function more accurately than a standard echocardiogram. It helps in planning the treatment or surgical intervention needed for heart defects.

Indications

• Unexplained chest pain
• Suspected congenital heart disease
• Unclear findings on a transthoracic echocardiogram
• Pre-operative and post-operative assessment of congenital heart defects
• Monitoring known cardiac anomalies

Preparation

• Fasting for at least 6 hours before the procedure
• Arranging for someone to drive the patient home post-procedure
• Stopping certain medications as directed by the healthcare provider
• Pre-procedure blood tests or imaging may be required

Procedure Description

1. Pre-Procedure: The patient receives instructions and signs consent. A sedative might be administered to help the patient relax.
2. Probe Placement: The throat is numbed with a local anesthetic spray. The flexible probe is then gently passed down the throat into the esophagus.
3. Image Acquisition: The probe emits sound waves to create images of the heart, which are recorded and displayed on a monitor.
4. Contrast Administration: If contrast is used, it is injected intravenously to enhance the images.
5. Interpretation: A cardiologist interprets the images to assess for congenital anomalies.
6. Report: A detailed report is prepared based on the findings.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital or an outpatient clinic equipped with specialized echocardiography facilities.

Personnel

• Cardiologist (specifically trained in echocardiography)
• Anesthesiologist or nurse anesthetist (if sedation is used)
• Registered nurses and echocardiography technicians

Risks and Complications

• Sore throat or minor discomfort (common)
• Rare risks include esophageal injury, bleeding, infection, or adverse reaction to sedation
• Complications are managed based on severity, often requiring prompt medical attention

Benefits

• Provides detailed images aiding in accurate diagnosis and treatment planning
• Less invasive with fewer risks compared to surgical alternatives
• Results are typically available shortly after the procedure

Recovery

• Observed for a short period post-procedure to ensure there are no immediate complications
• Sore throat and mild sedation effects may persist for a few hours
• Follow-up appointments as directed, and resumption of normal activities usually within a day

Alternatives

• Transthoracic echocardiography (TTE), which is less invasive but may offer less detail
• MRI or CT scans for congenital heart disease evaluation
• Pros and cons of alternatives: TTE is non-invasive and comfortable but may provide less detail, while MRI/CT offer detailed images but may not be suitable for all patients due to radiation or the need for contrast agents

Patient Experience

Patients may experience slight discomfort during probe insertion and throat soreness afterward. Sedation helps alleviate anxiety and discomfort. Pain management includes over-the-counter medications and throat lozenges. The entire experience is guided by healthcare professionals to ensure patient comfort and safety.