TEE in Non-cardiac Surgery: Indications, Contraindications, Probe Manipulation, and Certification

Transesophageal echocardiography (TEE) is a safe monitoring modality with broad applications in non-cardiac surgery. A moderate amount of exposure to its use and knowledge of the principles of echocardiography can yield the practitioner competent to make basic assessments of a patient’s cardiac status and help guide initial management decisions. The practitioner should also be able to determine when the nature of the surgery or the patient’s cardiovascular status necessitates a comprehensive examination by a board certified advanced echocardiographer. Each patient should be evaluated individually to assess for contraindications and potential complications associated with the use of TEE. Most complications are associated with probe insertion and manipulation and providers should ensure that these maneuvers are performed carefully and appropriately.