Recommendations for Performing Transoesophageal Echocardiography

Transoesophageal echocardiography (TEE) is a diagnostic tool with widespread utilization. Due to its unique potential in improving cardiological diagnosis, the procedure is increasingly applied in small hospitals, private practice, and new settings such as the emergency room. In spite of its frequent usage, there is no generally accepted standard protocol of the examination procedure, which is distinctly different from transthoracic echocardiography. Indeed, this procedure involves patient discomfort, carries a minute risk to the patient, and hence is not easily repeated. This paper represents an effort by the Subgroup on Transesophageal Echocardiography and Valvular Heart Disease of the Working Group Echocardiography of the European Society of Cardiology to state succinctly the essential points of the typical TEE exam in adults. The recommendations have been worded from ‘desirable’ to ‘mandatory’ according to the individual strength that the authors felt they carry. The wealth of potential indications, pathological findings, and variations in examination technique preclude a comprehensive review, which is available in textbooks and review articles. Similarly, it was not the purpose to write an educational text but rather to briefly describe the minimal requirements for a complete TEE examination. Similar efforts have been undertaken for intraoperative echocardiography by the American Society of Echocardiography.