[Transesophageal echocardiography (Part 4): clinical application. Part 2].
Transesophageal echocardiography (TEE) is extremely useful in evaluating native and prosthetic valves. TEE can reveal valvular lesions that may not be demonstrated by transthoracic approach. Nonetheless significant findings could be overlooked or misinterpreted even with TEE, since three-dimensional structures, motions, or flows are assessed through two-dimensional images. In addition, changes in the imaging conditions can considerably affect echo images, and thereby their interpretation. These inherent limitations of the technique must be kept in mind, and diagnosis should be based not only on echographic findings but on hemodynamic conditions and clinical observations. Other applications of intraoperative TEE include detection of intracardiac thrombi, tumors and vegetations, visualization of air bubbles, positioning of an intraaortic balloon and a coronary sinus catheter, evaluation of thoracic aortic lesions and pleural effusion, etc. In particular, TEE exhibits excellent sensitivity and specificity in diagnosing aortic dissection, and is indicated as a first-line examination when urgent evaluation is required for acute aortic dissection.
National Cardiovascular Center, Surgical Intensive Care Unit, Suita.
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D000784:Aortic Dissection / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D006325:Heart Atria; D006338:Heart Neoplasms / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging*; D006350:Heart Valve Prosthesis; D006801:Humans; D007432:Intraoperative Period; D012680:Sensitivity and Specificity