Transoesophageal Echocardiogram ( TOE)

A trans-oesophageal echo, abbreviated to TOE,  is an ultrasound of your heart performed from within the oesophagus, which lies right behind the heart. This leads to very clear pictures of the heart because unlike a normal transthoracic ultrasound, the sound waves do not need to travel past ribs, fat and lungs. It is particularly useful for looking at the back of the heart, clots in the heart, holes in the heart, abnormalities of valve function and of the aorta, which is the main artery leaving the heart.  

How is a TOE performed?

-A TOE is performed in an identical fashion to an endoscopy, a procedure designed to look at the stomach. This procedure is only done as an outpatient in a hospital environment. The patient is required to be fasted for 4-6 hours. An intravenous cannula is placed in the vein on the back of the hand and the patient is attached to monitoring equipment. The back of the throat is sprayed with local anaesthetic spray to numb this area and then sedation is administered. You would not be completely asleep during this procedure but heavily sedated and will not be aware of the procedure.

-After sedation is administered, a mouth guard is positioned in the mouth to protect your teeth and the TOE probe is place in the back of the throat and with swallowing is advanced into the oesophagus.

-The whole procedure may take between 5 and 15 minutes but you will be sedated for half an hour to an hour. After approximately one hour you will be allowed to have a sip of water and assuming the local anaesthetic in the throat has worn off, you will be allowed to eat and drink normally.

-After approximately 2-3 hours you will be discharged, although under no circumstances should you drive for the rest of that day.  

Are there any risks with a TOE?

Any cardiac procedure does carry the potential for risk. However, a TOE is extremely safe with the risk of damage to the throat or oesophagus less than 1 in approximately 10,000. You may have a slight discomfort in the throat for 24-48 hours, depending on how easy your procedure was, but this will settle down.