Transesophageal assessment of left atrial thrombus using a 3.3-mm monoplane probe.
OBJECTIVE
Our study was designed to demonstrate that transesophageal echocardiography using a 3.3-mm monoplane probe can accurately evaluate the left atrium for patients with arrhythmias before cardioversion.


BACKGROUND
Standard probes cause discomfort during intubation requiring sedation, but miniature probes do not.


METHODS
With topical anesthesia alone, a 3.3-mm probe was used for transesophageal echocardiography in 60 patients. After intravenous sedation, standard transesophageal echocardiography was then performed.


RESULTS
In 51 of 60 patients, the left atrium was visualized with the 3.3-mm probe. In 43 of 51 patients the appendage was clear. A thrombus was seen in 7 patients on both studies. In one patient spontaneous echocontrast was seen only with the 3.3-mm probe (sensitivity 100%, specificity 97%). In 9 of 60 patients, the appendage could not be assessed.


CONCLUSIONS
In many patients the 3.3-mm probe can visualize the appendage and obviate the need for sedation. Technical advances will improve image quality with miniature probes.
Brosnan
Rhoda B
RB
Duke University Medical Center, Durham, North Carolina 27710, USA. brosnanr@juno.com
Crowley
Anna Lisa
AL
Russo
Cheryl A
CA
Jollis
James G
JG
D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008904:Miniaturization; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D014159:Transducers