Transesophageal echocardiographic findings in patients with orthotopic heart transplantation.

This study was performed to determine the diagnostic value of TEE in recipients of orthotopic heart transplantation. Findings on TEE were compared with those of TTE in 30 patients with orthotopic heart transplantation. Transesophageal echocardiography identified left atrial appendage and flow across the interatrial septum ... findings not detected by TTE. In addition, pronounced bulging of the interatrial septum was seen in six patients by TEE and not by TTE. Spontaneous echo contrast (smoke) in the atria was detected by TEE in 14 patients and by TTE in one patient. Abnormal geometry of the atria and donor-recipient atrial anastomosis was identified in all patients by TEE and TTE. Our findings suggest that TEE should be selectively utilized in the operating room, in patients with suspected atrial thrombi, and in those with clinically significant right ventricular volume overload to assess integrity of interatrial anastomosis.