Cardiothoracic Anesthesiology - Echocardiography (TTE and TEE)

Echocardiography (TTE and TEE)

Echocardiography produces a real-time image of the heart via ultrasound imaging, and can be performed in two or three dimensions. There are two ways of performing echocardiography depending on placement of echocardiography probe: transthoracic or transesophageal.

In transthoracic echocardiography (TTE), the probe is placed over the patient's chest wall, while in transesophageal echocardiography (TEE or TOE in the UK), the probe is placed into the esophagus.

Regardless of technique, each probe contains a transducer. While transmitting signals, it converts electrical energy to acoustic energy. When receiving signals, it converts acoustic energy to electrical energy, which is processed by the machine to form an image. Various techniques are employed to manipulate the data, including Doppler imaging.

Transesophageal echocardiography has rapidly become the most powerful monitoring technique and diagnostic tool for the management of cardiac surgical patients, primarily due to the transesophageal echocardiogram probe location and ability to be used intraoperatively. It provides the detailed information about the structure and function of the heart/great vessels in real time, allowing the cardiothoracic anesthesiologist to precisely manage patient physiology while providing updates and direction to members of the surgical team throughout the pre, intra, and post operative time frame of patient care.

After successful completion of the fellowship with subspecialty training in TEE, cardiothoracic anesthesiology fellows may sit for examination leading to board certification in echocardiography. The examination, also known as the PTEeXAM, is administered by the National Board of Echocardiography (NBE). . In addition to passing the test, fellows can become board certified only after performing 150 exams as well as reviewing an additional 150 exams with a board certified cardiologist/cardiothoracic anesthesiologist.