Transesophageal Echocardiography (TEE)

Transesophageal echocardiography (TEE) is a new cardiovascular ultrasound technology developed in recent years. It uses a special exploration position and high-quality image display, which opens up a new window for cardiac angiography and expands transthoracic ultrasound. The scope of the TEE has made up for the lack of TEE, and it has gradually become more widely used in clinical practice. Basic Information Specialist classification: cardiovascular examination classification: ultrasound Applicable gender: whether men and women apply fasting: fasting Tips: Patients with TEE should be confirmed to have no history of dysphagia, esophageal disease and hepatitis B, and antigen-antibody system tests should be negative. Fasting for 4~6h, 2% or 3 times with 2% lidocaine throat spray, sedative for patients with nervousness. Normal value Left atrial diameter Male 26.77±2.96mm; Female 27.31±2.33mm; Left indoor path End diastolic Male 49.10±9.80mm; Female 43.30±4.20mm; End of contraction Male 28.60 ± 5.20mm; Female 28.80±5.40mm; Right atrial diameter Male 14.0 (6.8 ~ 28.33) mm; Female 13.9 (5.5 to 21.2) mm; Left ventricular outflow tract inner diameter Male 28.6 ± 4.1mm; Female 27.2±3.3mm; Right ventricular outflow tract inner diameter Male 28.9 ± 2.4mm; Female 28.2±2.2mm; Aortic root diameter Male 27.1±2.6mm; Female 26.2±1.9mm; Left ventricular posterior wall thickness End of contraction Male 14.4±2.0mm; Female 12.3±1.8mm; End diastolic Male 9.1 ± 1.1mm; Female 9.0±1.1mm; Septal thickness Male 9.85 ± 0.30mm; Female 9.32±1.20mm; Right ventricular wall thickness Male 4.4±0.4mm; Female 4.1±0.6mm; Left ventricular posterior wall amplitude Male 12.0 ± 1.6mm; Female 10.8±1.4mm; Aortic root ascending rate Male 41.2 ± 6.6mm / s; Female 34.4 ± 8.9 mm / s; Aortic root descending speed Male 72.0 ± 6.7mm / s; Female 60.3 ± 3.9mm / s; Stroke work index Male 47.2 ± 4.7 ml / m2; Female 45.3±4.8ml/m2; The average value is 46.5±4.87ml/m2; Ejection fraction Male 68±4.8% (0.684±0.048); Female 68.8±4.5% (0.668±0.045); The mean value is 68.5±4.7% (0.685±0.047); The area of ​​the mitral valve mouth is 4-6 cm2; Aortic valve area of ​​2.5 ~ 3.5cm2; The area of ​​the tricuspid valve is 10cm2; The pulmonary valve orifice area is 2.5 to 3.5 cm2. Clinical significance Unclear observation of transthoracic echocardiography, especially for artificial valve dysfunction (stenosis, paravalvular leakage), left and right atrial appendage lesions (thrombus), valvular sputum (aortic, mitral, tricuspid) , dissection of aortic aneurysm, atrial septal defect, patent foramen ovale and location of the foramen ovale, coronary artery (left main, left anterior descending, etc.), intraoperative monitoring (correction, supplementation of preoperative diagnosis, evaluation of immediate surgery) Effect) and so on. Low results may be diseases: aortic stenosis, aortic regurgitation, thoracic aortic aneurysm, high atrial myocardial infarction may be disease: thoracic descending aortic aneurysm, combined valvular disease, esophageal syphilis, congenital mitral valve Malformation, right atrium and inferior vena cava leiomyomas Before inspection: Patients who underwent TEE were identified as having no history of dysphagia, esophageal disease, and hepatitis B. The antigen-antibody system should be negative. Fasting for 4~6h, 2% or 3 times with 2% lidocaine throat spray, sedative for patients with nervousness. When checking: Take the left lateral position, and the supine position can be taken during intraoperative monitoring. Inspection process Intubation method: The esophageal ultrasound probe is routinely disinfected according to the gastroscope sterilization method. The front end of the probe is coated with a lubricant of about 150°, and the patient bites the dental pad. The surgeon quickly inserts the probe into the esophagus through the oral cavity to the pharynx. The multi-plane probe automatically scans continuously from 0-180° through the button on the probe handle. 1, the bottom of the heart: the probe is about 25-30cm from the incisor to find the bottom of the heart, according to the degree of the angle of the probe, can show the short axis of the aortic root, ascending aorta, aortic valve, long axis of the pulmonary artery (main pulmonary artery, Pulmonary bifurcation, left and right pulmonary artery), pulmonary valve, pulmonary vein, right ventricular outflow tract, left atrial appendage, atrial septum, etc. 2, four-cardiogram sectional view: increase the insertion depth of the esophageal probe, can show a similar view of the four-heart cavity of the sternum, as well as the coronary sinus, inferior vena cava, left ventricular outflow tract to aortic valve. 3, left ventricle short-axis cross-sectional view: the probe continues to insert to the level of the bottom of the stomach, can show the left ventricle short-axis cross-sectional view, observed left ventricular mitral papillary muscle, right ventricular oblique section, thoracic aorta. Observations: The same as the two-dimensional echocardiography of the transthoracic wall, color Doppler flow imaging and spectral Doppler examination were performed. Not suitable for the crowd Not suitable for people: severe heart failure, severe heart rhythm disorder, esophageal disease, hepatitis B virus, dysphagia, etc. Adverse reactions and risks Mucosal injury: gentle intubation, avoiding excessive force and other factors causing damage to the oral esophageal mucosa.