• H F Kuecherer and E Foster.
• Department of Cardiology, University of Heidelberg, Germany.
• Cardiol Clin. 1993 Aug 1;11(3):475-87.

AbstractThe transesophageal approach has improved echocardiographic investigation of cardiac structure and function. As a new window to the heart with markedly improved resolution, TEE gives better insight into cardiac morphology and pathology than does precordial imaging. Specifically, the LA and mitral valve can be better visualized due to the immediate retrocardiac position of the imaging transducer. Similarly, TEE is also widely used to estimate left ventricular functional status. Specifically in the perioperative setting, methods have been developed and tested to analyze global and regional left ventricular function. In addition, methods of estimating left atrial pressure (pulmonary capillary wedge pressure) have recently been developed using pulsed Doppler echocardiography of pulmonary venous flow and interatrial septal dynamics. Transesophageal pulsed Doppler echocardiography of pulmonary venous flow provides a useful clinical tool to estimate pulmonary capillary wedge pressure reliably in the setting of impaired systolic function, diastolic dysfunction, or both. Furthermore, pulmonary venous flow is characteristically altered in patients with severe MR and can be useful in grading its severity. Transesophageal continuous wave Doppler echocardiography may prove useful to estimate systolic pulmonary artery pressure as another clinically useful hemodynamic parameter. Therefore, TEE adds significantly to the noninvasive assessment of cardiac hemodynamics.

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