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Transesophageal Echocardiography, or TEE, uses a probe inside the esophagus to give physicians clear photos of parts of the heart not seen as well via a regular echocardiogram, which is taken outside the chest. (Video: Peter Munk Cardiac Centre YouTube)​


​"It is clearly the most significant diagnostic tool that has been introduced into the cardiac surgery operating room over the last 15 years," says Dr. Chris Feindel, cardiac surgeon, Peter Munk Cardiac Centre, when speaking of Transesophageal Echocardiography, or TEE.

TEE is a diagnostic test that takes pictures of the heart with the use of a probe placed inside the esophagus, enabling physicians to see clear photos of parts of the heart that would not be as clear via a regular ​​echocardiogram, which is taken from outside the chest.​​​

In many ways, it is a lifeline for cardiologists, cardiac surgeons, anesthesiologists and other members of the multi-disciplinary teams working in a cardiac OR.

"Not only does it confirm why the patient is there in the first place, it  provides a critical and immediate assessment of the operation, assuring that the best possible outcome is achieved for the patient," says Dr. Feindel, a seasoned member of PMCC's cardiac surgery team. "It is also an excellent tool to uncover any additional issues not identified preoperatively that may need to be addressed."​


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Image of Dr. Chris Feindel
Dr. Feindel calls TEE the most "significant diagnostic tool introduced in the cardiac surgery OR over the last 15 years." (Photo: PMCC)

TEE is the focal point of an upcoming three-day conference – the 13th Annual Toronto Perioperative TEE Symposium, presented by UHN's Department of Anesthesiology and Division of Cardiac Surgery.

Running November 6-8, 2015, the Symposium will feature speakers from across North America sharing knowledge about and discussing point of care ultrasound, examining unique clinical cases and peering more deeply into the expanding capabilities of transesophageal echocardiogram in order to better harness its full potential to benefit patient care and outcomes.

"When you generate a 3D image, you can show it to anybody, and it really gives the feeling of what the actual anatomy is and it doesn't require a process of merging 2D slices to create a 3D model in your mind," says Dr. Massimiliano Meineiri, Anesthesiologist and Director of Perioperative Echocardiography, Toronto General Hospital.

"In terms of patient care, you can show the patient his or her own valve and show what the valve looks like before the operation, why the patient needs an operation and how the valve may look like after the operation is done. It gives everybody a better understanding of what the pathology is and likely guide the surgeon to do the best possible operation for that patient," he says.

Image of Dr. Wendy Tsang
Dr. Massimiliano Meineiri says the TEE “really gives the feeling of what the actual anatomy is.” (Photo: PMCC)

TEE enables physicians to: assess the structures and function of the heart, evaluate the effectiveness of surgery, determine the presence of many types of heart disease, and pinpoint cardiac abnormalities.

"Knowledge from this Symposium will let the practitioner understand how these new methods can make a difference in not only their practice but also improve their care of the patient by letting them use the newest techniques to make diagnoses and management plans," says Dr. Wendy Tsang, who, as a cardiologist at PMCC, is part of the physician-group tasked with imaging a patients' heart first in order to help establish a diagnosis. 

Adds Dr. Feindel, "Even though for decades we operated without TEE, today, operating without TEE, is like operating 'naked'!​

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