The role of transesophageal echocardiography in clinical use.

Transesophageal echocardiography (TEE) is not only an invaluable diagnostic tool for cardiac patients, but also is essential for cardiac monitoring in critically ill patients in cardiac and non-cardiac surgery settings and in the differential diagnosis of unexplained hemodynamic collapse. The advantage of TEE over transthoracic echocardiography (TTE) is usually clearer images, especially when viewing structures that are difficult to see transthoracically. TEE is essential in monitoring adult and congenital heart surgery perioperatively. The adequacy of the repair can be ensured immediately through a review of TEE images directly after surgery. Although TEE is considered to be relatively safe and noninvasive, TEE-associated complications, such as esophageal laceration, must be taken seriously. Recently, real-time three-dimensional (3D) TEE imaging has played an important role defining valvular and congenital abnormalities and aiding in operative and percutaneous repair.