TransösophagusEchokardiographie

Transösophagus, or transesophageal, describes procedures or imaging modalities that access or visualize structures via the esophagus. The term denotes the use of the esophageal route to approach thoracic or cardiac anatomy, often when external approaches provide lower resolution or are less feasible.

The most prominent application is transesophageal echocardiography (TEE). In this procedure, a specialized ultrasound transducer is passed into the esophagus to obtain high-resolution images of the heart, particularly posterior structures such as the left atrium and the mitral and aortic valves. TEE is frequently used for preoperative assessment, intraoperative monitoring during cardiac surgery, and in the evaluation of suspected endocarditis or aortic pathology, especially when transthoracic imaging is limited.

Another major use is endoscopic ultrasound (EUS) with the endoscope advanced into the esophagus. EUS combines endoscopic visualization with ultrasound to assess mediastinal and esophageal lesions, stage gastrointestinal cancers, and guide therapeutic interventions such as fine-needle aspiration or drainage of nearby fluid collections.

Safety, risks, and limitations: Most transesophageal procedures require sedation or anesthesia and continuous monitoring. Potential complications include sore throat, dental injury, esophageal irritation, perforation, bleeding, arrhythmias, and adverse anesthesia events. Contraindications include known esophageal perforation, significant esophageal disease (such as severe strictures, varices, or acute esophagitis) that would raise procedural risk, and circumstances where airway protection or patient cooperation cannot be ensured.

History and context: The transesophageal approach developed in the late 20th century and has since become integral in cardiology and gastroenterology, providing closer, higher-clarity access to cardiac and mediastinal structures when non-esophageal approaches are insufficient.