TRANSNASAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Transesophageal echocardiography has been used as a diagnostic tool in the critical care unit; However, longterm serial evaluation of ventri cular function with transesophageal echocardiography is difficult beca use of the current probe sizes and intolerance to prolonged oral intub ation. We performed 139 intubations (64 oral and 75 transnasal) with a new prototype probe in 128 patients referred for transesophageal echo cardiography. Transnasal intubation with the prototype probe was possi ble in 63/75 attempts. Oral intubation was successful in all 64 attemp ts. Patients tolerated transnasal intubation well when mildly sedated or awake. Two-dimensional echocardiographic views obtained with the na sal probe were similar to those obtained with a standard monoplane pro be. Image quality was rated as good or acceptable in nearly all cases. Transgastric short-axis imaging of the left ventricle combined with a coustic quantification provided stable left ventricular area waveforms . Using custom developed software we showed the feasibility of monitor ing left ventricular performance with minimal probe adjustment while g raphically displaying and updating left ventricular area and fractiona l area change. Thus, transesophageal echocardiography with a prototype miniaturized monoplane probe passed transnasally is feasible, safe, a nd well tolerated by patients. This probe provides excellent two-dimen sional echocardiographic images and may allow long-term echocardiograp hic monitoring of ventricular performance.