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Length of Procedure
Hospital Entry
Hospital Stay
Location
15-20 mins
Same Day as procedure. Procedure usually takes place at 12.00pm
Discharge same day, a few hours after procedure

Transoesophageal Echocardiogram (TOE)

What is a TransOesophageal Echocardiogram?
This diagnostic test looks at the structure of the heart, its chambers and valves. It also looks at the heart valve movement and the action of the two lower chambers called ventricles during the contraction (working) and resting stage of the heart muscle. To get the best images of the heart a probe ( right) is inserted into the throat and placed in close proximity to the heart. The probe is steered into position using the wheels on the hand unit. The probe emits high freqency sound waves which pass through the tissues of the throat,heart and chest. The different tissues reflect the sound waves differently and these are differences are picked up and measured by the equipment and converted into an image.

Benefits of the procedure
This procedure is an accurate way of assessing the heart's structure and function. The most common reasons for performing this test include assessing infection on the heart valve (endocarditis) prior to certain operations such as repair of the mitral valve, looking for birth defects of the heart (congenital heart disease).



Risks of the procedure
TOE requires introduction of the echo probe into and down the oesophagus. A sedative and spray are administered making the patient lightheaded or sleepy. Complications of these aspects of the procedure are very rare - a potential risk is a tear in the oesophagus caused by the operator when the probe is introduced which would require intervention. Problems will mainly occur with patients with prevailing problems of the oesophagus.

Pre procedure
The patient will have fasted on the day of the procedure, having had nothing to eat or drink 4-6 hours before the procedure.

On the day
The patient reports to ward 16 where the clerk will book them in.

Attending Staff
Usually attending the procedure is a cardiac technician, nurse and a doctor.
Specialists : Dr Raj Khattar - Consultant Cardiologist, Dr Wajdi Turkie - Research Fellow.

Procedure
The procedure takes place in a side room on ward 16 and is usually scheduled for around lunchtime and lasts around 15 to 20 minutes. The patient lies down, ECG equipment is attached to the chest, the patient is covered and a pillow placed under the head. Before the procedure the patient will have a drug sprayed into the throat and a sedative administered by injection. The patient will begin to feel sleepy and may even fall asleep. The doctor will then introduce the echo probe. The machine records the readings from the probe and stores them on computer. Most patients are unaware during the procedure and usually do not remember anything about the procedure.

After the examination is complete the patient is moved from the TOE exam room to a bed on ward 16 to recover. Recovery usually takes a couple of hours. When the nurse is satisfied the patient is sufficiently recovered they will be allowed home.

Patients should not drive or and should be accompanied by a relative or friend for the journey home.

For a few hours after the procedure the patient may experience some discomfort swallowing but this will disappear over the following hours. There may be some bleeding in the throat which will settle after a short while.

Results
The results of the procedure will be forwarded in writing to the person who originally requested the test and be sent to the patient. The patient usually isn't sufficiently aware to absorb the information on the day of the procedure however the accompanying relative may be told the results on the day.

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