Transesophageal echocardiogram

Transesophageal echocardiogram (TEE) may be done to:

• Monitor heart function during surgery.
• Look for masses or blood clots in the upper left chamber (left atrium) of the heart.
• Check how well a replacement heart valve works.
• Measure the speed at which blood travels through the heart.
• Measure the blood pressure and speed of blood flow through the heart valves.
• Identify abnormal blood flow between the chambers of the heart (cardiac shunt).
• Help find out if you have endocarditis, which is an infection of the heart's valves or its inner lining (endocardium).
• Guide procedures done during cardiac catheterization.
• Help find out if you have a tear in the aorta (aortic dissection).

Before a TEE, your throat may be numbed with an anesthetic spray, gargle, or lozenge. This is to relax your gag reflex and to make it easier to insert the probe. Shortly before the procedure starts, an I.V. line will be placed in a vein in your arm. Medicine to decrease saliva and stomach secretions may be given through the I.V. A pain medicine and sedative will be given to you through the I.V. in your arm during the procedure. You should feel relaxed and drowsy but still alert enough to cooperate.

Your heart rate, breathing rate, and blood pressure will be monitored throughout the procedure. Also, a small device used to measure the amount of oxygen in your blood (pulse oximeter) may be attached to your finger or earlobe.

You will be asked to lie on your left side with your head tilted slightly forward. A mouth guard may be inserted to protect your teeth from the probe. Then the lubricated tip of the probe will be guided into your mouth while your doctor gently presses your tongue out of the way. You may be asked to swallow to help move the tube along. It may be helpful to remember that the probe is no thicker than many foods you swallow. When the probe is in your esophagus, it will be moved down gently to the level of your upper right heart chamber (atrium), and ultrasound images will be taken. You won't feel or hear the sound waves during the test.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Follow your doctor's instructions exactly about when to stop eating and drinking before the test. This may be about 8 hours.
• Be sure to tell your doctor about any problems you have with your stomach or esophagus.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.