Transesophageal echocardiography for clinical decision making

Transesophageal echocardiography was initially developed to supplement an inadequate precordial echocardiographic examination. With high frequency transducers providing high resolution and detailed imaging, the technique has gained importance as a diagnostic tool in a considerable number of patients with cardiovascular disease, by providing unique information. In this study, the diagnostic utility and benefits of the application of transesophageal echocardiography in the clinical practice of cardiology are investigated. The first part of the study (Chapter 1) provides a review of the technological developments in transesophageal echocardiography. This is followed by a description of the comparative diagnostic value and limitations of precordial and transesophageal echocardiography. Subsequently, the transesophageal cross-sectional echocardiographic anatomy; the execution of the transesophageal procedure; the indications; the contraindications; the limitations; the technical perspectives and recommendations for training are described. Finally, a survey of the Thoraxcenter experience is presented. An overview of the diagnostic value of trans esophageal echocardiography in solving diverse clinical problems is discussed in Chapter 2. In Chapters 3 to 7 the unique advantages of transesophageal echocardiography are described for the diagnosis of thoracic aorta pathology, the assessment of native and Bjork Shiley mitral valve regurgitation by color Doppler flow imaging, for diagnosis of infective endocarditis, the detection of intracardiac thrombus, and visualization of the left coronary artery