Transesophageal Echocardiogram (TEE)

A TEE is a dedicated specialised echocardiogram that involves inserting a long flexible probe (transducer) into the esophagus (the long food pipe that connects your mouth to the stomach). It allows your doctor to view your heart without the lungs and ribs obstructing the view. This technique can, therefore, record better images of your heart as compared to the normal transthoracic echocardiogram (TTE).

Is it necessary for me to have the TEE?

After weighing the risks and benefits of this procedure, your Cardiologist would have determined on the basis of your condition that it is more beneficial for you to undergo this procedure. This particular procedure is very helpful to give further information to your Cardiologist if you have one or more of the following conditions

  • Congenital heart disease
  • Heart valves abnormalities of which a form of repair may be planned
  • Infection of the heart valves
  • The possibility of a blood clot in the left side chambers of your heart
  • Surgically repaired or replace valves.

How can I prepare for the procedure?

You will need to be fast (no food and water) for at least 6 hours prior to the procedure.

What can I expect during the procedure?

  • This procedure is performed by your Cardiologist with the assistance of the Cardiac sonographer and Cardiac nurse.
  • You will be asked to undress from waist up and change into a gown. Your Cardiac Sonographer will put on sticky patches (electrodes) on your chest which will be connected via cables to the heart rate monitor. A blood pressure cuff will be worn as well. Your Cardiac Nurse will insert an intravenous cannula in order for sedative medications to be given.
  • During the procedure, your blood pressure and heart rate will be monitored closely.
  • Before the start of the procedure, you will be given numbing medications to your throat (oral spray) and sedative medications via the intravenous drip to help you relax. Oxygen therapy will also be given.
  • Dentures will have to be removed and you will wear a mouthpiece in order to keep your mouth open.
  • The flexible probe will be inserted into your mouth, and you will be encouraged to repeat swallowing actions. This is to facilitate the insertion of the probe into your eosophagus.
  • The whole procedure will take approximately 20-30minutes and you will feel sleepy for most of the investigation.
  • Upon completion of the procedure, your Cardiologist will remove the flexible probe from your oesophagus and you will be transferred to the observation room.
  • You will be allowed to be discharge after about 2hrs. Please arrange for someone to pick you up as you will not be allowed to drive as you were given sedation.

Are there any risks that I should know?

  • Your esophagus may be damaged when inserting the flexible probe. This incidence of this complication is very rare though.
  • There may be a risk of aspiration (food contents going into your lungs from your esophagus). As long as you have properly fasted for at least 6hrs, the complication rate for aspiration is very low.
  • Your oxygen level in your blood may decrease due to the sedation. However, you are given oxygen therapy and your level will be monitored very closely.