[Clinical usefulness of a new echocardiographic window: the transesophageal approach]

The image quality of standard echocardiograms can be unsatisfactory for various reasons such as pulmonary disease, obesity, chest deformities. The introduction of transesophageal echocardiography has solved these problems and provided a new acoustic window to the heart and mediastinum. Its superior imaging resolution and increased sensitivity allow cardiac structure and function to be visualized in great detail. The procedure has proven to be a valuable means of intraoperative and perioperative monitoring of left ventricular performance and in the evaluation of surgical results. In critically ill patients, diagnoses missed at surface echocardiography, including aortic dissection, left atrial masses, native or prosthetic valve vegetations, have clearly been identified by transesophageal window. In awake patients, the procedure is well accepted and associated with no major complications. On the basis of our initial experience, we conclude that esophageal approach complements standard two-dimensional, Doppler, and color flow examinations, and is a major advance in the care of patients with cardiovascular disease.