[Clinical use of transesophageal echocardiography]

Transoesophageal echocardiography (TE) presents a new window in echocardiography. Experience obtained in the first 70 TE studies performed in 66 patients is reported. The patients' age ranged between 15 and 75 years, there were 36 females and 30 males. Sixty studies were done in awake patients and 10 studies in anesthetized or intubated patients. TE indications included suspected mitral prosthetic valve dysfunction: 20, tumor or thrombus: 11, search for source of embolism: 10, infective endocarditis: 5, congenital heart disease: 8, intraoperative decision-making: 7, acute postoperative hypotension: 3, suspected aortic dissection: 3 and others. There was no unsuccessful intubation or complication. The most important results: the differentiation of left atrial tumor and thrombus by the presence or absence of spontaneous echocontrast, the role of TE in the intraoperative and early postoperative decision making and the diagnosis in rare clinical situations (multiplex myxoma; tricuspid prosthetic valvular regurgitation caused by pacemaker electrode dislocation). It is concluded that TE is a unique diagnostic technique which provides invaluable clinical informations and facilitates therapeutic decision making. It is a safe procedure both in awake and anesthetized patients therefore in certain indications it should supplement standard echocardiographic technique in routine clinical practice.