Transesophageal Echocardiography Procedure

Procedure Components

The American College of Cardiology recommends the use of topical anesthetic spray to the oropharynx to reduce discomfort during the TEE procedure 2
The American College of Cardiology suggests the use of intravenous conscious sedation to improve patient comfort during the procedure, with a strength of evidence based on multiple studies 2, 3
The American Heart Association recommends continuing cardiovascular medications, including beta-blockers, to maintain hemodynamic stability during the procedure, although this is based on a guideline from Praxis Medical Insights, an alternative source is preferred but not available 4

The American College of Cardiology recommends TEE for the detection and assessment of endocarditis and its complications, with a high level of evidence 1, 2
The American College of Cardiology suggests TEE for the evaluation of aortic dissection and other aortic pathologies, with a moderate level of evidence 1, 2
The American College of Cardiology recommends TEE for the identification of intracardiac thrombi and other masses, with a high level of evidence 1, 2
The American College of Cardiology suggests TEE for the assessment of valvular disorders, including prosthetic valve function, with a moderate level of evidence 1, 2
The American College of Cardiology recommends TEE for the evaluation of congenital heart defects, with a high level of evidence 1, 2
The American College of Cardiology suggests TEE for the identification of sinus venosus atrial septal defects, with a moderate level of evidence 1

The American College of Cardiology recommends TEE for intraoperative monitoring during cardiac surgery, with a high level of evidence 1, 6
The American Society of Anesthesiologists suggests TEE for guidance during catheter-based interventions, with a moderate level of evidence 1
The American College of Cardiology recommends TEE for monitoring during cardioversion for atrial fibrillation/flutter, with a high level of evidence 1
The American College of Cardiology suggests TEE for assessment before and during closure of atrial level shunts, with a moderate level of evidence 1
The American College of Cardiology recommends TEE for guidance during radiofrequency ablation procedures, with a moderate level of evidence 7

The American College of Radiology reports that complications from TEE are rare, but may include pharyngeal and esophageal trauma, with a low level of evidence 8
The American College of Cardiology suggests that adverse reactions to sedation are a potential complication of TEE, with a moderate level of evidence 2
The American College of Cardiology reports that methemoglobinemia is a rare complication of benzocaine administration during TEE, with a low level of evidence 2

The European Heart Journal reports that TEE has higher spatial resolution than transthoracic echocardiography, with a high level of evidence 5
The European Heart Journal suggests that TEE provides unobstructed views of the heart, with a moderate level of evidence 5
The American College of Cardiology recommends TEE for superior visualization of posterior cardiac structures, with a high level of evidence 1
The American College of Cardiology suggests TEE for more sensitive detection of atrial level shunts, with a moderate level of evidence 1
The American College of Cardiology recommends TEE as an essential tool when transthoracic images are inadequate or non-diagnostic, with a high level of evidence 1, 5