A transesophageal echocardiogram (TEE) is a minimally invasive procedure, typically performed after a standard echocardiogram has revealed a possible problem with the heart muscle or valve. The TEE has shown benefit in evaluating the function of an artificial heart valve, in discovering blood clots in the heart, and in helping diagnose congenital or other types of heart disease.

A TEE is also used during heart-related surgical procedures, where it provides the surgeon with important data such as whether the heart valve should be repaired or replaced. It can provide immediate assessment of a valve and detect abnormalities that need to be addressed during the surgery.

During a transesophageal echocardiogram (TEE), a small transducer attached to a tube (echoprobe) is inserted into the esophagus via the mouth and throat after the patient has been mildly sedated. This will not affect the patient’s ability to breathe freely but may temporarily interfere with swallowing. Once positioned in the esophagus, the transducer can transmit very clear images of the heart’s size, structures and function.

A TEE can take up to 90 minutes. Additional time may also be needed for the physician or technician to record information about the patient and answer all of the patient’s questions. People who are scheduled for a TEE are encouraged to arrange for transportation home from the test, because they will be given a calming medication (sedative) that often leaves them feeling groggy or light-headed.

Just before the TEE, the patient will be asked to remove dentures and oral prostheses and to lie down on the left side on the examination table. An intravenous (IV) solution is started and a mild sedative can be administered. Heart and blood pressure monitoring will begin and continue throughout the procedure. Finally, an anesthetic spray is sprayed into the throat to reduce the gag reflex and help prevent coughing or gagging.

The physician will insert the echoprobe and feed it to the esophagus, which runs from the throat to just behind the heart. The patient may be asked to swallow in order to help move the echoprobe into location. Some discomfort at this stage is normal. Once in place, imaging begins. The transducer at the tip of the probe may be periodically repositioned or advanced in the esophagus to obtain particular views.

When imaging is completed, the echoprobe is withdrawn. Monitoring of vital signs will continue after the procedure until the sedative wears off. At that time, the patient will be able to leave the hospital or diagnostic center. People cannot eat or drink anything until the anesthetic spray has worn off and the gag reflex is restored to prevent possible choking.

Complications are rare, but could include:

People who have additional questions or concerns are encouraged to speak with their physician about the procedure.