Standard transesophageal imaging and planes
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After induction of anesthesia and intubation of the patient’s trachea, the TEE probe can be inserted. By lifting the mandible together with the tongue with one hand, the probe can then be introduced with other hand. For successful introduction, it is important to direct the tip of the probe towards the midline of the pharynx. The depth of anesthesia must be adequate to prevent undesirable reactions to the stress of the introduction of the probe, which is, at worst, comparable to the stress produced by tracheal intubation. Before introduction, the tip of the probe should be lubricated, and the steering controls of the probe should be unlocked so that it can gently follow the contours of the pharynx. In cases where blind introduction of the probe is difficult, direct visualization of the proximal esophagus with the laryngoscope is helpful. The technique is almost identical to tracheal intubation and therefore should be easy for an anesthetist to handle. As there is a potential risk of causing esophageal damage (or even perforation) force should never be used when introducing the probe. Similarly, the probe should not be advanced or withdrawn while the tip is flexed or retroflexed or in the locked position.
KeywordsAortic Valve Right Coronary Artery Transesophageal Echocardiography Ventricular Outflow Tract Atrial Appendage
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