What is Transesophageal Echocardiography (TEE)?
Echocardiography is the examination of the internal structure and functions of the heart by means of sound waves (ultrasound). In some cases where the commonly used surface (transthoracic) echocardiography method is insufficient, echocardiography may be required through the esophagus. These conditions can be listed as follows: investigation of the presence of clot or infection in the heart, evaluation of artificial valve functions, search for ruptures of the main artery-aorta, examination of heart defects, and determination of the severity of heart valve insufficiency, evaluation of the success of the procedure during and after heart valve repair or closure of heart defects.
Sometimes, the TEE method is used in cases where the chest structure of the patient does not allow adequate quality echocardiographic images due to lung disease or deformity. In some cases, contrast agents (dyed drugs) can be used to better visualize the inner border of the heart, to show the blood supply to the heart muscle, and to detect intra-cardiac shunts during TEE.

How is the patient prepared before the Transesophageal Echocardiography procedure?
The test is started after 4-12 hours of fasting. Diabetes patients should consult their doctor. Patients with complaints such as allergies, asthma, and high eye pressure, difficulty in swallowing, nasal congestion, and problems related to the esophagus and stomach should inform these conditions to the doctor who will make the test. If there is a removable tooth and palate prosthesis in the mouth, it should be removed before the procedure.
How is transesophageal echocardiography performed?
TEE is a semi-invasive examination. Just before the procedure, vascular access is opened in order to provide intravenous drug administration when necessary. In order to suppress the gag reflex and allow the patient to adapt to the procedure, the mouth and soft palate area are locally anesthetized with the help of an anesthetic spray. Intravenous sedatives are administered for the procedure and patient comfort. In cases where patient compliance cannot be achieved during the examination, if the procedure is absolutely necessary, sedation is performed under the control of the anesthesiologist under heart-lung resuscitation conditions.
The cardiologist who will perform the procedure explains how to swallow the tube. A mouthpiece is placed in the mouth so that the patient does not bite the tube. The gel-lubricated TEE probe is slowly advanced through the esophagus. When swallowing the probe, it is normal to have gurgling and nausea, this is temporary. In the meantime, inhalation and exhalation is made through the nose. Necessary heart images are recorded on video and pictures are taken. At the end of the procedure, your doctor will inform you about the findings. The average review time is 15-20 minutes.
Contrast agent (dyed drug) application
Different dyed drugs are used in cases where dyed drugs must be applied during TEE. The most preferred method is to apply the saline solution intravenously by mixing it with air by shaking. This application does not have any side effects. In addition, different dyed drugs specially produced for this process are also used. Allergic side effects of these dyed drugs can be seen very rarely.
Considerations after transesophageal echocardiography procedure
Nothing should be eaten or drunk until two hours after the examination. Since the drugs used for sedation during the examination may cause dormancy and drowsiness for a while, vehicles and machinery should not be used until this situation is completely gone.
In addition, there may be soreness and loss of sensation in the throat for 1 or 2 days. This is a temporary condition and does not require treatment.
Are there adverse events and risks associated with transesophageal echocardiography?
The TEE procedure is generally a reliable examination method. Although very rare, the following undesirable side effects may be encountered: Decreased oxygen in the blood (hypoxia), sudden decrease or increase in blood pressure, sudden rhythm disturbance, and very little fresh blood coming from the mouth.