Name of the Procedure:

Transesophageal Doppler Measurement of Cardiac Output (including probe placement, image acquisition, and interpretation per course of treatment)
Common Name: Transesophageal Doppler
Technical Terms: Transesophageal Echocardiography (TEE), Cardiac Output Monitoring

Summary

Transesophageal Doppler is a procedure that uses ultrasound technology to measure the amount of blood the heart pumps out. It involves inserting a specialized probe through the esophagus to get a closer, clearer picture of the heart. This helps doctors monitor the heart's function during treatment.

Purpose

This procedure helps diagnose and monitor heart conditions by providing detailed real-time measurements of cardiac output. It is especially useful in critically ill patients or during surgical procedures to ensure the heart is functioning properly.

Indications

• Severe heart disease
• Critically ill patients requiring continuous cardiac monitoring
• Patients undergoing major surgery, especially heart surgery
• Conditions resulting in hemodynamic instability, such as sepsis or shock

Preparation

• Fasting for at least 6-8 hours before the procedure.
• Adjustment of certain medications as directed by the doctor.
• Pre-procedure evaluation, including blood tests and imaging studies.

Procedure Description

1. The patient is positioned, typically lying on their side.
2. Sedation or local anesthesia is administered to ensure comfort.
3. An ultrasound probe is carefully inserted through the mouth and into the esophagus.
4. The probe captures images and Doppler measurements of the heart.
5. Data is analyzed for cardiac output and heart function assessment.
6. The probe is gently removed after the necessary information is obtained.

Tools & Equipment: Ultrasound probe, monitoring equipment.

Anesthesia/Sedation: Mild sedation or local anesthetic to the throat.

Duration

The procedure typically lasts between 30 minutes to an hour.

Setting

This procedure is performed in a controlled environment such as a hospital, usually in an ICU or operating room.

Personnel

• Cardiologist or anesthesiologist specialized in transesophageal echocardiography
• Trained nursing staff
• Anesthesiologist (if sedation is used)

Risks and Complications

• Mild throat discomfort or temporary hoarseness
• Risk of aspiration or breathing issues
• Esophageal or gastric injury
• Rare complications include severe esophageal injury or arrhythmia

Benefits

• Provides accurate real-time monitoring of cardiac function
• Helps in making timely and effective treatment decisions
• Vital for managing critically ill patients or those undergoing complex surgeries
• Non-invasive compared to some alternative methods

Recovery

• Patients may experience mild throat soreness, typically resolving in a day or two.
• No eating or drinking until the numbness wears off.
• Follow-up appointments as recommended by the healthcare provider.
• Resume normal activities as advised.

Alternatives

• Transthoracic echocardiography: less invasive but offers less detailed images.
• Pulmonary artery catheterization: invasive with higher risk but provides similar monitoring.
• Non-invasive cardiac output monitoring: less detailed but completely non-invasive.

Patient Experience

During the procedure, the patient may feel slight pressure or discomfort as the probe is inserted and positioned. Sedation greatly enhances comfort. After the procedure, the throat may be sore and swallowing might be uncomfortable temporarily. Pain management and comfort measures include throat lozenges and mild analgesics if necessary.