Transoesophageal echocardiography (including 3D and peri-procedural imaging)

A transoesophageal echocardiogram (often shortened to TOE) is a specialised investigation performed at Wythenshawe Hospital. The procedure is performed as a day case procedure under sedation. The procedure is similar to an endoscopy procedure which many people have heard of. A cannula (drip) will be inserted into your arm. You will then have some local anaesthetic sprayed at the back of your throat to numb the throat. Next you will have three stickers placed on the shoulders/upper chest which will monitor the heartbeat and a monitor placed on your finger to monitor your oxygen levels. A second person (usually a member of our nursing team) will be present throughout the test to monitor your vital signs. You will be given some oxygen via the nose, asked to place am mouthguard in your mouth (to protect your teeth) and asked to lay on your left-hand side. You will then usually be given a small amount of sedation to make you feel relaxed and sleepy. An ultrasound probe (a long thin probe about the width of your little finger) will be gently introduced into your gullet and stomach. This probe has an ultrasound beam on the end and is able to take very detailed ultrasound pictures of the heart as it lies very close to the gullet and stomach. The doctor or sonographer performing the test will usually spend 15-30 minutes taking detailed pictures of the heart. Following the test you will stay in the ward for a few hours whilst the effects of the sedation wear off.

Your Healthcare Professional may recommend this test if they need very detailed pictures of the heart, especially to look at the heart valves and for blood clots in the heart. The test is a very safe and straightforward procedure and we perform hundreds of these tests at Wythenshawe every year. It is common to have a sore throat following the procedure for 1-2 days. Other rare complications include damage to the mouth and teeth, the risks of sedation and a small risk of damage to the oesophagus. Your Healthcare Professional will discuss this with you when they ask you to sign the consent form.

Transoesophageal echocardiography (TOE) is sometimes also performed as part of keyhole procedures such as Transcatheter aortic valve implantation (TAVI), transcatheter mitral valve intervention (Mitraclip) and ablation procedures. If you are undergoing a ‘dual’ procedure including a transoesophageal echocardiogram (TOE) then you will usually have this procedure performed under general anaesthetic and this will be explained to you prior to your procedure.