Skip to main content

Transesophageal Echocardiography from Upper Respiratory Endoscopic Processes

  • Chapter
  • First Online:
Upper Airway Disorders and Noninvasive Mechanical Ventilation

Abstract

Transesophageal echocardiography (TEE) is a semi-invasive procedure that has an important place in the perioperative management of cardiac surgery and in guiding diagnosis and treatment in hemodynamically unstable patients. TEE is used to evaluate the anatomical structure, pressure, and function of the heart valves, aorta, atrium and ventricles, atrioventricular septum, pulmonary vein, and pulmonary arteries. Intraoperative TEE is very important in guiding the treatment/surgery for heart valve repair or replacement in cardiac surgery and increasing the chance of success of the surgery. Transthoracic echocardiography may sometimes be insufficient in the evaluation of echocardiographic functions in critically ill patients. TEE provides fast and necessary information at the bedside for the management of patients who are hemodynamically unstable for any reason. Complication rates related to TEE performed in the outpatient clinic, perioperative period, and intensive care units vary. Complications related to TEE performed in the intensive care and intraoperative period may be slightly higher. Most of the complications of TEE are associated with probe insertion and manipulation. In cases where TEE is absolutely contraindicated, it is recommended using alternative echocardiographic imaging methods.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Prabhu M, Raju D, Pauli H. Transesophageal echocardiography: instrumentation and system controls. Ann Card Anaesth. 2012;15:144–55.

    Article  PubMed  Google Scholar 

  2. Hilberath JN, Oakes DA, Shernan SK, Bulwer BE, D’Ambra MN, et al. Safety of transesophageal echocardiography. J Am Soc Echocardiogr. 2010;28:1115–27. https://doi.org/10.1016/j.echo.2010.08.013.

    Article  Google Scholar 

  3. Saphir JP, Cooper JA, Kerbavez RJ, Larson SF, Schiller NB. Upper airway obstruction after transesophageal echocardiography. J Am Soc Echocardiogr. 1997;10:977–8.

    Article  CAS  PubMed  Google Scholar 

  4. Savage RM, Aronson S, Shanewize JS, Mossad EB, Licina MG, et al. Intraoperative echocardiography. In: Estafanous FG, Barash GP, Reeves JG, editors. Cardiac Anaesthesia-principles and clinical practice. 2nd ed. Philadelphia: Lippincott; 2001. p. 237–94.

    Google Scholar 

  5. Practice guidelines for perioperative transesophageal echocardiography. An updated report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on transesophageal echocardiography. Anesthesiology. 2010;112:1084–96.

    Google Scholar 

  6. Kihara C, Murata K, Wada Y, Hadano Y, Ohyama R, Okuda S, et al. Impact of intraoperative transesophageal echocardiography in cardiac and thoracic aortic surgery: experience in 1011 cases. J Cardiol. 2009;54:282–8.

    Article  PubMed  Google Scholar 

  7. Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (ACC/AHA/ASE Committee to update the 1997 guidelines for the clinical application of echocardiography). J Am Soc Echocardiogr. 2003;16:1091–110.

    PubMed  Google Scholar 

  8. Kerut EK, Mcllwain EF, Plotnick GD. Basic principles of ultrasound physics. In: Kerut EK, Mcllwain EF, Plotnick GD, editors. Handbook of Echo-Doppler interpretation. Oxford: Blackwell Publishing; 2004. p. 1–6.

    Chapter  Google Scholar 

  9. Maslow A, Perrino A.C. Principles and technology of two-dimensional echocardiography. In: Perrino AC, Reeves S. T, editors. A practical approach to transesophageal echocardiography. 2nd ed. Philadelphia: Lippincott; 2003. p. 3–23.

    Google Scholar 

  10. Bashein G, Dtemer PR. Physical principles, ultrasonic image formation and artifacts. In: Sidebotham D, Merry A, Legget M, editors. Practical perioperative Transoesophageal echocardiography. 2nd ed. Philadelphia: Elsevier Saunders; 2011. p. 2–21.

    Chapter  Google Scholar 

  11. Lawrence JP. Physics and instrumentation of ultrasound. Crit Care Med. 2007;35(8 Suppl):314–22.

    Article  Google Scholar 

  12. Leitman M, Peleg E, Rosenblat S, Sucher E, Wolf R, et al. Transesophageal echocardiography: an overview. Isr Med Assoc J. 2000;3:198–206.

    Google Scholar 

  13. Fisher E, Stahl J, Budd J, Goldman M. Transesophageal echocardiography: procedures and clinical application. J Am Coll Cardiol. 1991;18:1333–48.

    Article  CAS  PubMed  Google Scholar 

  14. Cormier B, Vahanian A. Echocardiography and indications for surgery. Eur Heart J. 1995;16:68–71.

    Article  PubMed  Google Scholar 

  15. Poelaert J, Schmidt C, Colardin F. Transesophageal echocardiography in the critically ill. Anaesthesia. 1998;53:55–68.

    Article  CAS  PubMed  Google Scholar 

  16. Mayo PH, Narasimhan M, Koenig S. Critical care transesophageal echocardiography. Chest. 2015;148(5):1323–32. https://doi.org/10.1378/chest.15-0260.

    Article  PubMed  Google Scholar 

  17. Kallmeyer IJ, Collard CD, Fox JA, Body SC, Shernan SK. The safety of intraoperative transesophageal echocardiography: a case series of 7200 cardiac surgical patients. Anesth Analg. 2001;92:1126–30.

    Article  CAS  PubMed  Google Scholar 

  18. Hogue CWJR, Lappas GD, Creswell LL, Ferguson TB, Sample M, Pugh D, et al. Swallowing dysfunction after cardiac operations. Associated adverse outcomes and risk factors including intraoperative transesophageal echocardiography. J Thorac Cardiovasc Surg. 1995;110:517–22.

    Article  PubMed  Google Scholar 

  19. Lennon MJ, Gibbs NM, Weightman WM, Leber J, Ee HC, et al. Transesophageal echocardiography-related gastrointestinal complications in cardiac surgical patients. J Cardiothorac Vasc Anesth. 2005;19:141–50.

    Article  PubMed  Google Scholar 

  20. Hulyalkar AR, Ayd JD. Low risk of gastroesophageal injury associated with transesophageal echocardiography during cardiac surgery. J Cardiothorac Vasc Anesth. 1993;7:175–7.

    Article  CAS  PubMed  Google Scholar 

  21. Owall A, Stahl L, Settergren G. Incidence of sore throat and patient complaints after intraoperative transesophageal echocardiography during cardiac surgery. J Cardiothorac Vasc Anesth. 1992;6:15–6.

    Article  CAS  PubMed  Google Scholar 

  22. Sriram K, Khorasani A, Mbekeani KE, Patel S. Tongue necrosis and cleft after prolonged transesophageal echocardiography probe placement. Anesthesiology. 2006;105:635.

    Article  PubMed  Google Scholar 

  23. Flynn AE, Verrier ED, Way LW, Thomas AN, Pellegrini CA. Esophageal perforation. Arch Surg. 1989;124:1211–5.

    Article  CAS  PubMed  Google Scholar 

  24. Min JK, Spencer KT, Furlong KT, DeCara JM, Sugeng L, et al. Clinical features of complications from transesophageal echocardiography: a single-center case series of 10, 000 consecutive examinations. J Am Soc Echocardiogr. 2005;18:925–9.

    Article  PubMed  Google Scholar 

  25. Massey SR, Pitsis A, Mehta D, Callaway M. Oesophageal perforation following perioperative transoesophageal echocardiography. Br J Anaesth. 2000;84:643–6.

    Article  CAS  PubMed  Google Scholar 

  26. Chan KL, Cohen GI, Sochowski RA, Baird MG. Complications of transesophageal echocardiography in ambulatory adult patients: analysis of 1500 consecutive examinations. J Am Soc Echocardiogr. 1991;4:577–82.

    Article  CAS  PubMed  Google Scholar 

  27. Stevenson JG. Incidence of complications in pediatric transesophageal echocardiography: experience in 1650 cases. J Am Soc Echocardiogr. 1999;12:527–32.

    Article  CAS  PubMed  Google Scholar 

  28. Venticinque SG, Kashyap VS, O’Connell RJ. Chemical burn injury secondary to intraoperative transesophageal echocardiography. Anesth Analg. 2003;97:1260–1.

    Article  PubMed  Google Scholar 

  29. Colreavy FB, Donovan K, Lee KY, Weekes J. Transesophageal echocardiography in critically ill patients. Crit Care Med. 2002;30:989–96.

    Article  PubMed  Google Scholar 

  30. Dark PM, Singer M. The validity of trans-esophageal Doppler ultrasonography as a measure of cardiac output in critically ill adults. Intensive Care Med. 2004;30:2060–6.

    Article  PubMed  Google Scholar 

  31. Valtier B, Cholley BP, Belot JP, de la Coussaye JE, Mateo J, Payen DM. Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. Am J Respir Crit Care Med. 1998;158:77–83.

    Article  CAS  PubMed  Google Scholar 

  32. Slama MA, Novara A, Van de Putte P, Diebold B, Safavian A, et al. Diagnostic and therapeutic implications of transesophageal echocardiography in medical ICU patients with unexplained shock, hypoxemia, or suspected endocarditis. Intensive Care Med. 1996;22:916–22.

    Article  CAS  PubMed  Google Scholar 

  33. Stevenson JG, Sorensen GK. Proper probe size for pediatric transesophageal echocardiography. Am J Cardiol. 1993;72:491–2.

    Article  CAS  PubMed  Google Scholar 

  34. Click RL, Abel MD, Schaff HV. Intraoperative transesophageal echocardiography: 5-year prospective review of impact on surgical management. Mayo Clin Proc. 2000;75:241–7.

    Article  CAS  PubMed  Google Scholar 

  35. Greene MA, Alexander JA, Knauf DG, Talbert J, Langham M, et al. Endoscopic evaluation of the esophagus in infants and children immediately following intraoperative use of transesophageal echocardiography. Chest. 1999;116:1247–50.

    Article  CAS  PubMed  Google Scholar 

  36. Andropoulos DB, Stayer SA, Bent ST, Campos CJ, Fraser CD. The effects of transesophageal echocardiography on hemodynamic variables in small infants undergoing cardiac surgery. J Cardiothorac Vasc Anesth. 2000;14:133–5.

    Article  CAS  PubMed  Google Scholar 

  37. Rosenberger P, Shernan SK, Loffler M, Shekar PS, Fox JA, Tuli JK, et al. The influence of epiaortic ultrasonography on intraoperative surgical management in 6051 cardiac surgical patients. Ann Thorac Surg. 2008;85:548–53.

    Article  PubMed  Google Scholar 

  38. Hubbard RM, Santiago G, Uppu S, Roy S, Gautam N, et al. Diagnosis of extrinsic upper esophageal compression utilizing video laryngoscopy in an infant following failed transesophageal echocardiogram probe placement. Semin Cardiothorac Vasc Anesth. 2020;24:360–3. https://doi.org/10.1177/1089253220954692.

    Article  PubMed  Google Scholar 

  39. Hahn RT, Abraham T, Adams MS, Bruce CJ, Glas KE, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2013;26:921–64. https://doi.org/10.1016/j.echo.2013.07.009.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Tekeli, A.E., Kılıç, M. (2023). Transesophageal Echocardiography from Upper Respiratory Endoscopic Processes. In: Esquinas, A.M., De Vito, A., Barbetakis, N. (eds) Upper Airway Disorders and Noninvasive Mechanical Ventilation. Springer, Cham. https://doi.org/10.1007/978-3-031-32487-1_35

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-32487-1_35

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32486-4

  • Online ISBN: 978-3-031-32487-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics