Transesophageal echocardiography with a single-plane probe. Long-axis views of the heart from the apical (transgastric) approach.
The literature suggests that during transesophageal echocardiography (TEE), a short-axis view can be obtained in the gastric position using a single-plane probe.  Recently, we have found that a long-axis apical display of the heart can be achieved by placing the tip of the probe in the fundus of the stomach.  In a 3-month period, we attempted to obtain this view in 54 consecutive patients.  Twelve of the patients had TEE done under general anesthesia, while the other 42 patients had the procedure performed under sedation with midazolam at hospital bedside or as an outpatient.  The long-axis transgastric view was obtained in 51 of the 54 patients (94%).  The image quality was graded subjectively as good in 39 (72%) and fair in the other 12 patients (22%).  This view helped to establish the diagnosis in eight patients (15%) and to increase the level of confidence about the accuracy of the diagnosis in 23 (43%) other patients.  Four patients' findings are described.  We conclude that the new long-axis transgastric view is easy to obtain, does not add much time to the usual TEE study, does not add to the low complication rate of TEE, and may help to interrogate the distal structures of the heart.
Gadasalli
S N
SN
University of Wisconsin Medical School, Milwaukee Clinical Campus, Sinai Samaritan Medical Center.
Sarnoski
J S
JS
Kubota
J
J
Schmidt
D H
DH
Gal
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005748:Gastric Fundus; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged