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Updated: Jan 24, 2026
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Transesophageal echocardiography
Andrzej Szyszka1, Edyta Płońska-Gościniak2
1Department of Cardiology, Medical University in Poznan , Poznan , Poland.
Insights
Transesophageal echocardiography (TEE) complements transthoracic echocardiography for visualizing difficult cardiac structures. It
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Procedures
Background:
- Transthoracic echocardiography (TTE) is a standard imaging technique for cardiac assessment.
- Certain cardiac structures and pathologies may not be adequately visualized with TTE alone.
- Transesophageal echocardiography (TEE) offers an alternative imaging approach for enhanced visualization.
Purpose of the Study:
- To outline the indications and contraindications for performing transesophageal echocardiography.
- To describe the technical aspects and procedural requirements for TEE.
- To emphasize the complementary role of TEE in relation to TTE.
Main Methods:
- TEE utilizes a multiplanar probe inserted via the esophagus for detailed cardiac imaging.
- Specific probe positions and depths (low, mid, high, transgastric views) are employed for optimal visualization.
- The procedure requires patient consent, performed by accredited cardiologists in accredited laboratories.
Main Results:
- TEE is indicated for assessing cardiac sources of embolism, endocarditis, prosthetic valve dysfunction, and thoracic aorta abnormalities.
- It is crucial for pre-procedural assessment (valvular repair, septal defect closure) and intraoperative monitoring.
- Serious complications are rare, but contraindications include recent meals and risk of esophageal perforation or GI bleeding.
Conclusions:
- Transesophageal echocardiography is a valuable, complementary diagnostic tool when transthoracic echocardiography is insufficient.
- Proper patient selection, procedural technique, and accredited settings are essential for safe and effective TEE.
- TEE provides comprehensive cardiac imaging, aiding in diagnosis and management of various cardiovascular conditions.
Abstract:
Transthoracic and transesophageal examinations should be considered as mutually complementary. Transesophageal echocardiography is performed in cases of a justified need to visualize structures that are poorly visible or invisible on transthoracic echocardiogram. Primary indications for transesophageal echocardiography include an assessment of cardiac source of embolism, suspected endocarditis, suspected prosthetic valve dysfunction, an assessment of thoracic aorta and other vessels, an assessment prior to valvular repairs and closures of septal defects, intraoperative monitoring of cardiac or percutaneous interventions, ablation, non-diagnostic transthoracic examination, especially in patients after cardiac surgeries. Serious complications after transesophageal examination are very rare. This type of examination should not be performed in patients who consumed a meal 4-6 hours before the test, or when there is a risk of esophageal perforation and massive gastrointestinal bleeding. The test should be performed in an appropriately accredited laboratory and by a cardiologist with an individual accreditation. Transesophageal echocardiography may be performed in an outpatient setting. It should be recorded using the available media. The description should include comprehensive answers to questions in the referral. Transesophageal examination requires patient consent. It is performed using a multiplanar probe, which ensures the best conditions for imaging of the heart and the thoracic aorta. First of all, the reason for referral should be diagnosed. Depending on the setting depth, the following views may be distinguished: low transesophageal view (the probe is advanced approximately 30 cm from the teeth), mid transesophageal view (the probe is advanced approximately 30 cm from the teeth), high transesophageal view (the probe is advanced approximately 25-30 cm from the teeth), transgastric subcardiac view (the probe is advanced approximately 35-40 cm from the teeth), transgastric five-chamber view (the probe is advanced deeper than in the subcardiac view and with a stronger anterior flexion of the probe, aortic (the probe should be rotated at about 180°).
Abstract:
Transthoracic and transesophageal examinations should be considered as mutually complementary. Transesophageal echocardiography is performed in cases of a justified need to visualize structures that are poorly visible or invisible on transthoracic echocardiogram. Primary indications for transesophageal echocardiography include an assessment of cardiac source of embolism, suspected endocarditis, suspected prosthetic valve dysfunction, an assessment of thoracic aorta and other vessels, an assessment prior to valvular repairs and closures of septal defects, intraoperative monitoring of cardiac or percutaneous interventions, ablation, non-diagnostic transthoracic examination, especially in patients after cardiac surgeries. Serious complications after transesophageal examination are very rare. This type of examination should not be performed in patients who consumed a meal 4–6 hours before the test, or when there is a risk of esophageal perforation and massive gastrointestinal bleeding. The test should be performed in an appropriately accredited laboratory and by a cardiologist with an individual accreditation. Transesophageal echocardiography may be performed in an outpatient setting. It should be recorded using the available media. The description should include comprehensive answers to questions in the referral. Transesophageal examination requires patient consent. It is performed using a multiplanar probe, which ensures the best conditions for imaging of the heart and the thoracic aorta. First of all, the reason for referral should be diagnosed. Depending on the setting depth, the following views may be distinguished: low transesophageal view (the probe is advanced approximately 30 cm from the teeth), mid transesophageal view (the probe is advanced approximately 30 cm from the teeth), high transesophageal view (the probe is advanced approximately 25–30 cm from the teeth), transgastric subcardiac view (the probe is advanced approximately 35–40 cm from the teeth), transgastric five-chamber view (the probe is advanced deeper than in the subcardiac view and with a stronger anterior flexion of the probe, aortic (the probe should be rotated at about 180°).
