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[Transesophageal echocardiography. Indications and clinical usefulness]
F Depeursinge1, J C Stauffer, M Payot
1Division de cardiologie, CHUV, Lausanne.
Insights
Transesophageal echocardiography (TOE) provides valuable clinical information beyond transthoracic echocardiography (TTE), aiding diagnosis and treatment decisions in over half of patients. This advanced cardiac imaging technique demonstrated excellent tolerance and safety in the study population.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Transthoracic echocardiography (TTE) is a standard non-invasive cardiac imaging modality.
- Transesophageal echocardiography (TOE) offers an alternative perspective for cardiac assessment.
- Optimizing the clinical utility of TOE requires direct comparison with TTE.
Purpose of the Study:
- To compare the diagnostic contributions of transesophageal echocardiography (TOE) versus transthoracic echocardiography (TTE).
- To evaluate the additional clinical information provided by TOE.
- To assess the impact of TOE findings on patient management and treatment decisions.
Main Methods:
- Prospective comparative study involving 52 patients (outpatients, hospitalized, surgical).
- Both TOE and TTE were performed on all participants.
- Data collected included diagnostic yield, additional information obtained, and influence on treatment.
Main Results:
- TOE provided unsuspected diagnoses in 12 cases and additional useful information in 15 cases.
- Surgical treatment decisions were based on TOE findings alone in 8 patients.
- Clinically useful additional information from TOE was observed in 52% of patients.
Conclusions:
- Transesophageal echocardiography offers significant added clinical value over transthoracic echocardiography.
- TOE is particularly beneficial for diagnosing cardiogenic embolism, endocarditis, valvular dysfunction, and aortic dissection.
- TOE demonstrated excellent patient tolerance with no major complications, supporting its expanded clinical application.
Abstract:
To optimize the clinical applications of transesophageal echocardiography (TOE), we have compared the contribution of TOE with that of transthoracic echocardiography (TEE). TOE and TTE were performed in 19 outpatients, 17 hospitalized patients and 16 surgical patients (33 males and 19 females, mean age 53.3 +/- 16.8 years). TOE obtained a diagnosis unsuspected from TTE in 12 cases, and additional useful clinical information was obtained by TOE in 15 cases. Surgical treatment was decided on the basis of TOE alone in 8 cases. Patient tolerance of TOE was excellent and no major complications occurred. In conclusion, additional information obtained by TOE was clinically useful in about half of patients (52%), in particular in the diagnosis of cardiogenic embolism and in clinically suspect endocarditis, valvular dysfunction or aortic dissection.