Transesophageal two-dimensional echocardiography: its role in solving clinical problems.

The diagnostic value of transesophageal two-dimensional echocardiography is described in 32 patients in whom precordial echocardiography or angiography, or both, failed to establish a definitive diagnosis. All attempted transesophageal studies were completed without complication and the referral question was definitively answered. Nineteen patients were subsequently submitted to surgery. In 18 of them, the transesophageal echocardiographic diagnoses were proven correct; in 1 patient, the diagnosis was proven partially incorrect. In the 13 unoperated patients the transesophageal echocardiographic diagnoses were not independently confirmed but were assumed correct because incontrovertible images were obtained. These results indicate that transesophageal echocardiography significantly extends the diagnostic capabilities of echocardiography.