Introduction to Transesophageal Echocardiography

Richard Sheu, MD, G. Burkhard Mackensen, MD, PhD, Jay Pal, MD, PhD, Gabriel Aldea, MD


Technological advances along with marked enhancement in data processing and analytical capabilities is ushering in a dramatic and unrelenting evolution in medical imaging. Along with computed tomography (CT) and magnetic resonance imaging (MRI), transesophageal echocardiography (TEE) evolved from 2-dimensional (2D), to 3D, and now 4D with high-definition capabilities. Several technological breakthroughs in scanner design, beam formation, image acquisition and display, as well as automated quantification, along with improvement in temporal and spacial resolution have enabled TEE to provide superior assessment and definition of patient anatomy, pathology, and physiology. Given its accuracy, fidelity, timeliness, and relative accessibility, TEE is able to comprehensively present nuanced anatomy and data in an anatomically intuitive manner to all cardiovascular specialists. Based on these qualities, TEE enhances many aspects of pre-procedural diagnosis and planning, intraprocedural therapies (for both open- and catheter-based intervention), and complex postprocedural care.

TEE has become a central pillar of collaboration and essential communication between cardiac anesthesiologists, cardiologists, interventional cardiologists, and cardiac surgeons and has transformed patient-focused and tailored therapies. This chapter attempts to define and review the fundamental and advanced aspects of TEE as well as current terminologies in order to promote these essential collaborations.

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Last updated: March 3, 2023