Clinical applications of transesophageal echocardiography

Matsuzaki, M.; Toma, Yuichiro; Kusukawa, R

doi:10.1016/1053-0770(91)90346-u

Cited by 15 publications

(19 citation statements)

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“…Consequently, TEE improves diagnostic information in various cardiovascular diseases compared with conventional transthoracic echocardiography. [1][2][3][4][5] In contrast to conventional echocardiography, TEE is a semi-invasive procedure. The examination may be associated with some discomfort for the patient, and the procedure is not free of risk.…”

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confidence: 99%

Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations.

et al. 1991

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BACKGROUND During the past few years, transesophageal echocardiography (TEE) has been increasingly used in clinical cardiology; data concerning the practicability and safety of the technique, however, are rare. METHODS AND RESULTS This report analyzes the experience of 15 European centers performing TEE studies for at least 1 year. At the time of this survey, 10,419 TEE examinations had been attempted or performed in these institutions. These TEE examinations were carried out by 54 physicians, 53.7% of whom had been trained in endoscopic techniques. Within the same time period, 160,431 precordial echocardiographic examinations were performed in the 15 institutions; the ratio between TEE and transthoracic studies averaged 9.03 +/- 6.4% (range of the 15 centers, 1.4-23.6%). Of the 10,419 patients, 9,240 (88.7%) were conscious inpatients or outpatients at the time of the TEE examination; the vast majority of the conscious patients did not receive intravenous sedation before TEE. In 201 cases (1.9%), insertion of the TEE probe was unsuccessfully attempted because of a lack of patient cooperation and/or operator experience (98.5%) or because of anatomical reasons (1.5%). In 90 of 10,218 TEE studies (0.88%) with successful probe insertion, the examination had to be interrupted because of the patient's intolerance of the echoscope (65 cases); because of pulmonary (eight cases), cardiac (eight cases), or bleeding complications (two cases); or for other reasons (seven cases). One of the bleeding complications resulted from a malignant lung tumor with esophageal infiltration and was fatal (mortality rate, 0.0098%). CONCLUSIONS This multicenter survey documents that TEE studies are associated with an acceptable low risk when used by experienced operators under proper safety conditions.

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confidence: 99%

Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations.

et al. 1991

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“…7 However, only a few investigations emphasizing the importance of aortic lesions in stroke, which can be detected by TEE, have been performed. 8 " 10 This study describes our attempts to clarify the importance of atherosclerotic changes in the aorta as an embolic source of stroke using this new technique.…”

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confidence: 99%

Aortogenic embolic stroke: a transesophageal echocardiographic approach.

Toyoda

Yasaka

Nagata

et al. 1992

Stroke

147

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Background and Purpose:We studied the frequency and grade of atherosclerotic changes in the thoracic aorta and their significance as embologenic lesions in patients with stroke.Methods: Using transesophageal echocardiography, we evaluated complicated lesions in the thoracic aortas of 62 patients who met our clinical criteria for embolic stroke. A complicated lesion was defined as a raised lesion with an irregular surface or acoustic shadow based on a comparative study of echocardiographic and histopathologic findings. The results were compared with plain radiographic findings and in some cases with computed tomographic or aortographic findings.Results: Twenty-six patients (42%) showed complicated aortic arch lesions on echocardiogram. Transesophageal echocardiography brought us more abundant information than other techniques. Aortic knob calcification by plain radiography correlated well with the presence of echocardiographically complicated lesions, suggesting its utility for rough screening of atherosclerotic changes. Fifty-two patients had other potential embolic sources in the heart or cervical arteries. Among the remaining 10 patients without extra-aortic embolic sources, three showed complicated lesions and were diagnosed as having aortogenic embolic stroke.Conclusions: Aortic atherosclerosis should be recognized as an embolic source of stroke and the advantage of transesophageal echocardiography recognized in its evaluation. (Stroke 1992;23:1056-1061 KEY WORDS • cerebrovascular disorders • echocardiography • embolism

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“…Biplane TEE examination was performed with an Aloka UST-5271S-5 probe first, and then multiplane TEE examination was performed with an Aloka UST-5280S-5 probe (Figure 1). Biplane and multiplane techniques were performed according to standardized protocols similar to those described previously [15][16][17][18]. Two separate complete studies were performed on each patient, with acquisition of images beginning at the transgastric level and progressing to the upper esophageal level.…”

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confidence: 99%

Application of a Miniaturized Biplane Transesophageal Echocardiographic Probe in Adults

et al. 2004

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Background. Standard multiplane transesophageal echocardiographic probes have large transducer tips that could increase patient discomfort, especially during esophageal intubation. A miniaturized biplane probe has been developed for pediatric use; however, its utility for adult patients is unknown. Methods.The miniaturized biplane imaging was tested in 48 anesthetized, ventilated adult patients during cardiac surgery and was compared with the standard multiplane imaging. We evaluated the image quality of cardiac structures and thoracic aorta using a five-grade scoring system. We also measured the left ventricular end-diastolic dimension (LVEDD, mm) and the peak flow velocity (cm/s) of the left atrial appendage (LAA) by pulsed-wave Doppler.Results. Esophageal intubation with the multiplane probe was unsuccessful in 1 patient, although this patient was successfully intubated with the biplane probe. There were no complications with either probe. The image qualities of the left ventricle, mitral valve, aortic valve, and ascending aorta by the biplane probe were inferior to those by the multiplane one. On the other hand, left atrium (LA), LAA, interatrial septum, aortic arch, and descending aorta were as well visualized by the biplane probe as by the multiplane one. The values of LVEDD and peak flow velocity of LAA were not different between the probes. LAA thrombus in 2 of 47 patients and aortic dissection (Stanford type A) in 7 were also well detected by both methods.Conclusions. The resolution of the two-dimensional images in the near fields of the miniaturized biplane probe was as good as the standard multiplane one. The miniaturized biplane probe was found to be applicable to the detection of LA or LAA thrombus and assessment of LAA function in adults.(J Echocardiogr 2004; 2: 83-89)

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Clinical applications of transesophageal echocardiography

Cited by 15 publications

References 0 publications

Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations.

Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations.

Aortogenic embolic stroke: a transesophageal echocardiographic approach.

Application of a Miniaturized Biplane Transesophageal Echocardiographic Probe in Adults

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