Transoesophageal Echocardiogram (TOE)
A TOE is an echocardiogram obtained from a flexible probe that is passed through the mouth to the oesophagus (gullet). This gives very high quality images of the heart and the valves in 2D and 3D. Sometimes the images obtained from the chest wall by a standard transthoracic echocardiogram (TTE) are not adequate to diagnose certain heart conditions, and a TOE is then required.
Common indications for a TOE
- To look for causes of a stroke such as blood clots, a small hole in the heart (PFO), abnormalities of a valve or plaque in the aorta.
- To look for infection on one of the heart valves
- To show the exact mechanism of leaking (regurgitation) of the mitral valve in someone who may be a candidate for a repair of the mitral valve
- To help make a precise diagnosis in someone with a congenital heart defect such as an ASD (hole in the heart)
- To assess whether there is any problem with the aorta
- To make sure there is not a blood clot in the heart before a cardioversion or electrical procedure in patients with atrial fibrillation.
- To get more information before certain procedures such as device closure of the left atrial appendage
How is it done?
The procedure is done either in the Mercy CCU or in one of the Catheter labs at the Mercy Hospital or Southern Cross Hospital. It is important to have nothing to eat or drink for 6 hours prior to the test. Your doctor may instruct you to take some of your medications with a small glass of water 2 hours before the test. An intravenous line is placed in an arm vein by the nurse or doctor and you will be given oxygen through small prongs in your nose. You will have ECG electrodes placed on your chest and your blood pressure measured. The doctor will discuss the test with you in detail before starting and you are then asked to sign a consent form. The throat is then sprayed with local anaesthetic and intravenous sedation is given until you are comfortably sedated. The test usually takes up to 20 minutes and should not be painful or uncomfortable but you may have a slightly sore throat afterwards.
After the test
Observation is required for a short time, usually 2 hours, after the test. You are advised not to drive, operate heavy machinery or make any legal binding decisions for 12 hours afterwards because of the sedation that has been given. A report will be sent to the referring doctor, and the cardiologist who has performed the test will explain the results after the procedure