The anatomical location of the transesophageal echocardiographic transducer during a short-axis view of the left ventricle.

This study was performed to clarify the location of a transesophageal echocardiographic (TEE) transducer when obtaining the short-axis view of the left ventricle (S-LV). The depth of the probe tip from the incisors when obtaining a S-LV, the relationship to the diaphragm, and the location of the cardia of the stomach using a gastroscope attached to the TEE probe were measured in 24 patients undergoing coronary artery bypass grafting. The location of the transducer relative to the cardia and diaphragm was determined. The study demonstrated that when obtaining a S-LV, the transducer was in the stomach in 72.7%, at the cardia in 13.6%, and in the esophagus in 13.6% of the patients. The predominantly intragastric position of the transducer suggests that gastric diseases should be included as contraindications to TEE. When the probe was advanced about 40 cm from the incisors, some resistance was often encountered by the TEE operator at about the level of the diaphragm. Careful manipulation is mandatory to avoid tissue damage by the probe. Visualization of the S-LV can be disturbed by gas in the stomach. This is a specific problem in anesthetized patients because gas is often pushed into the stomach at the time of induction.