NEW MINIATURIZED VS CONVENTIONAL BIPLANE TRANSESOPHAGEAL TRANSDUCERS - RECENT EXPERIENCES IN ADULTS

A subset of patients experiences substantial discomfort on examination with transesophageal echocardiography using the conventional echoscop e, whereby the dimensions or the probe play a decisive role. Miniaturi zed biplane transducers have recently become available (2 x 32 crystal s; dimensions 9.5 x 8.7 mm; circumference approx. 30% less than the co nventional echoscope), which allow ultrasound examination at 3.5, 5.0 and 7.0 MHz. A prospective study was carried out in 70 patients to com pare difficulties on insertion of the probe, subjective evaluation by the patient during examination, and the 2D-image as well as Doppler an d color-coded Doppler quality of the miniaturized biplane echoscope. I n 43 patients, intubation of the esophagus proved less difficult with the smaller instrument, it was more difficult in 8 cases. 54 patients reported that the discomfort was definitely easier to bear on use of t he narrow instrument. Concomitant parasympathicolytic medication was n eeded with the smaller probe in 4 cases, and 11 times with the convent ional echoscope. The quality of the 2D-image attained by the miniaturi zed probe was naturally lower. Employing multi-Hertz technology at a f requency of 7 MHz, however, imaging of the anatomy was excellent in th e nearfield of 5-6 cm, and nearly equivalent to that of the convention al probe (5 MHz). The quality of PW- and CW-Doppler as well as color-c oded Doppler information was identical. Whenever examination with a co nventional echoscope promises to be difficult, or when sedation is con traindicated due to a severe illness or respiratory insufficiency, tra nsesophageal echocardiography should be considered with a smaller bipl ane probe at higher frequencies.