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What Is Transesophageal Echocardiography (TEE)?

Transesophageal echocardiography (TEE) is an advanced ultrasound technique used to obtain high-resolution images of the heart and thoracic aorta. Instead of placing the ultrasound probe on the chest, the probe is inserted into the esophagus, which lies directly behind the heart.

Because the esophagus sits so close to the heart and the aorta, TEE provides clearer and more detailed images than standard echocardiography in many situations.

Stanford Health Care. (n.d.). Transesophageal echocardiogram. https://stanfordhealthcare.org/medical-tests/t/transesophageal-echocardiogram.html
Stanford Health Care. (n.d.). Transesophageal echocardiogram. https://stanfordhealthcare.org/medical-tests/t/transesophageal-echocardiogram.html

🔬 Why Use the Esophagus?

Think of it like trying to take a picture through a wall versus standing right next to the object.

  • In a regular transthoracic echocardiogram (TTE), ultrasound waves must pass through the chest wall, ribs, and lungs.

  • With TEE, the probe is positioned right behind the heart, allowing doctors to see structures much more clearly.

This makes TEE especially useful for evaluating valves, the aortic root, and the thoracic aorta.

🫀 What Structures Can TEE Evaluate?

TEE provides detailed visualization of several important cardiovascular structures:

  • Aortic valve

  • Mitral valve

  • Tricuspid valve

  • Left atrium and left atrial appendage

  • Interatrial septum

  • Aortic root

  • Ascending aorta

  • Descending thoracic aorta

  • Prosthetic heart valves

Because of this, TEE is an essential imaging tool in cardiology, cardiac surgery, and aortic surgery.

🔎 When Is TEE Commonly Used?

Doctors use TEE when they need more precise information than standard echocardiography can provide.

Common uses include:

  • Evaluating valvular heart disease

  • Detecting infective endocarditis

  • Looking for blood clots in the left atrium

  • Diagnosing aortic dissection

  • Assessing thoracic aortic aneurysms

  • Guiding structural heart procedures

🛠️ TEE During Aortic Surgery

TEE plays a critical role during aortic surgery, helping surgeons evaluate the heart and aorta in real time before, during, and after the operation.

Before surgery

TEE helps confirm:

  • The location and extent of aortic disease

  • Whether the aortic valve is functioning properly

  • The presence of aortic regurgitation

During surgery

TEE helps the surgical team:

  • Guide cannulation for cardiopulmonary bypass

  • Monitor heart function

  • Evaluate the repair or replacement of the aorta

After the repair

Before finishing the procedure, TEE is used to confirm:

  • Normal blood flow

  • Proper valve function

  • Absence of complications such as leaks or residual dissection

For surgeons, TEE acts like a real-time imaging guide, helping ensure the repair is successful before the patient leaves the operating room.

⚙️ How the Procedure Works

During TEE:

  1. The patient receives sedation or anesthesia.

  2. A thin ultrasound probe is gently inserted through the mouth into the esophagus.

  3. The probe emits ultrasound waves that bounce off cardiac structures.

  4. These echoes are converted into live images of the heart and aorta.

The procedure usually takes 15–30 minutes, but during surgery it remains in place to continuously monitor the heart.

📌 Key Takeaway

Transesophageal echocardiography is a powerful imaging tool that provides high-resolution views of the heart and thoracic aorta. Its ability to visualize cardiac structures in detail makes it essential for diagnosis, surgical planning, and intraoperative guidance—especially during complex aortic surgery.


This is all we have for you today folks. We hope this has been informative. Join us back here next Tuesday 

✍️ Have questions about cardiac imaging, heart surgery, or the aorta?

Let us know in the comments or check out our other educational posts!

ATT 

ALVARO JOSE MARTINEZ SANTACRUZ 



Bibliography


Johns Hopkins Medicine. (n.d.). Transesophageal echocardiogram. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/transesophageal-echocardiogram

National Center for Biotechnology Information. (2023). Transesophageal echocardiogram. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK442026/

Stanford Health Care. (n.d.). Transesophageal echocardiogram. https://stanfordhealthcare.org/medical-tests/t/transesophageal-echocardiogram.html

 
 
 

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