Esophageal Contrast Transesophageal Echocardiography for Mitral Valve Transcatheter Edge-to-Edge Repair in Severe Esophageal Achalasia.

IMAGE: Severe esophageal achalasia complicates transesophageal echocardiography (TEE), particularly in patients requiring mitral valve transcatheter edge-to-edge repair. We developed an innovative imaging technique called esophageal contrast TEE (ECTE), specifically designed for optimal imaging in complex conditions.

CASE SUMMARY: An 80-year-old man with chronic atrial fibrillation and severe mitral regurgitation was referred for mitral transcatheter valve edge-to-edge repair. His severe achalasia with esophageal dilation was challenging for adequate TEE because of poor probe-mucosa contact. Using ECTE, we optimized the probe position and enabled high-quality procedural guidance.

TAKE-HOME MESSAGE: ECTE can overcome imaging barriers in severe esophageal pathologies and enable safe and effective cardiac interventions.