Transesophageal echocardiography: Principal views

Abstract

Transesophageal echocardiography (TEE) uses echographic facilities mounted on a blinded gastroscope. It opens a new window to the heart and large vessels. The implementation of two-phased-array transducers perpendicular to each other has led to imaging capabilities in both transverse and longitudinal planes. TEE includes most imaging and Doppler facilities, as in transthoracic echocardiography. In this chapter, the different views are described as well as their main use in critically ill patients. TEE necessitates positioning of the probe in different locations in the esophagus and stomach. The transgastric view is used to evaluate left ventricular contractility, right ventricular dilation, and the left ventricular outflow tract (for cardiac output measurements). Midesophageal views are used to visualize simultaneously the four cavities of the heart and valves. TEE is also used to measure the diameter of the left ventricular outflow tract - and hence compute cardiac output in addition to the above Doppler measurements. The upper esophageal view is particularly useful for evaluating the superior vena cava, which can be predictive of preload responsiveness. © 2011 Springer-Verlag Berlin Heidelberg.