Feasibility of transesophageal echocardiography with a ten-French monoplane probe.

OBJECTIVES

We examined the feasibility of transesophageal echocardiography (TEE) using a 10F monoplane probe developed for intracardiac ultrasound (AcuNav, Acuson/Siemens, Mountain View, Calif).

BACKGROUND

Traditional TEE uses a 10- to 12-mm-diameter probe, and conscious sedation is customary to minimize patient discomfort. Because of its small size (3.2-mm diameter), the 10F monoplane probe can be inserted into the esophagus using only topical anesthesia. This provides the potential for a more easily tolerated examination.

METHODS

A total of 20 patients underwent a comprehensive TEE using an adult multiplane probe. Immediately afterward, the 10F monoplane probe was inserted into the esophagus and a targeted examination completed. The 10F monoplane studies were blindly reviewed by 3 observers for the study indication and for 16 diagnostic elements. These were graded against an expert's review of standard TEE.

RESULTS

The 10F monoplane probe was well tolerated in all patients. Observers A, B, and C answered the clinical question in 80%, 85%, and 100%, respectively, with the 10F probe. The percentage of clinical elements deemed evaluable was 71%, 78%, and 80%, respectively. Limitations included incomplete visualization of the mitral valve and a systematic underestimation of the severity of valve regurgitation.

CONCLUSIONS

The 10F monoplane probe is safe, well-tolerated, and capable of evaluating many clinical questions. Because of its small size, conscious sedation may not be necessary. It may be useful for targeted evaluations, for monitoring invasive procedures, or for intermediate or long-term monitoring in an intensive care department.