Transesophageal echocardiogram

It is an alternative way to perform anechocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus This allows image and Doppler evaluation which can be recorded.
It has several advantages and some disadvantages compared to a transthoracic echocardiogram (TTE).

advantages
The advantage of TEE over TTE is usually clearer images, especially of structures that are difficult to view transthoracicly (through the chest wall). The explanation for this is that the heart rests directly upon the esophagus leaving only millimeters that the ultrasound beam has to travel. This reduces the attenuation (weakening) of the ultrasound signal, generating a stronger return signal, ultimately enhancing image and Doppler quality. Comparatively, transthoracic ultrasound must first traverse skin, fat, ribs and lungs before reflecting off the heart and back to the probe before an image can be created. All these structures, along with the increased distance the beam must travel, weaken the ultrasound signal thus degrading the image and Doppler quality.
In adults, several structures can be evaluated and imaged better with the TEE, including the aorta, pulmonary artery, valves of the heart, both atria, atrial septum, left atrial appendage, and coronary arteries. TEE has a very high sensitivity for locating a blood clot inside the left atrium


disadvantages
TEE requires a fasting patient. The patient must follow the ASA NPO guidelines (i.e. usually not eat anything for six hours and not drink anything for two hours prior to the procedure.)
Requires a team of medical personnel
Takes longer to perform than TTE
May be uncomfortable for the patient
May require sedation or general anesthesia
There are some risks associated with the procedure (esophageal perforation[3]—1 in 10,000,[citation needed] and adverse reactions to the medication.)

Possible Complications
Complications are rare, but no procedure is completely free of risk. You will be given light sedation for the procedure. Your doctor will review a list of possible complications, which may include:

• Difficulty breathing
• Abnormal heart rhythms
• Bleeding or damage to the throat or esophagus

You may be at higher risk for complications if you:
Have throat problems
Had radiation therapy to the throat
Have a history of stomach ulcers or esophageal varices
Have strictures or narrowing of the esophagus
Have sleep apnea or severe respiratory disorders (eg, chronic obstructive