TOE (Trans-oesophageal echocardiogram)

What is a TOE?

A trans-oesophageal echocardiogram (TOE) is a procedure to look at your heart chambers and valves using a flexible telescope placed down your oesophagus (gullet). The telescope has an ultrasound scanner attached to it so your heart specialist can get close-up views of your heart.

What are the benefits of a TOE?

A TOE is usually used to help assess a problem with one of your heart valves and can show if it is possible to repair or replace that valve.

A heart specialist may use a TOE to identify any holes between heart chambers. They can also use a TOE during procedures to close any holes or insert devices.

If you need a controlled electric shock to treat an abnormal heart rhythm (cardioversion), a TOE is sometimes used first to check if you have a blood clot in any of your heart chambers.

Are there any alternatives to a TOE?

A trans-thoracic echocardiogram (TTE or echo) also uses ultrasound to give pictures of your heart.

An MRI or CT scan can give some information about your heart but a TOE is the best way to look closely at your heart valves.

What does the procedure involve?

A TOE usually takes 15 to 20 minutes. Your heart specialist or an anaesthetist may offer you a sedative to help you to relax.

Your heart specialist will place a flexible telescope (endoscope) into the back of your throat. Your heart specialist will use the scanner to take ultrasound images of your heart chambers and valves.

What complications can happen?

Some complications can be serious (overall risk of death: 1 in 10,000).

• sore throat
• allergic reaction
• breathing difficulties or heart irregularities
• heart attack (where part of the heart muscle dies) or stroke (loss of brain function resulting from an interruption of the blood supply to your brain) can happen if you have serious medical problems
• making a hole in your oesophagus or stomach (perforation)
• damage to teeth or bridgework
• bleeding
• infection
• incomplete procedure

How soon will I recover?

If you were not given a sedative, you should be able to go home and return to normal activities straightaway.

You should be able to return to work the next day unless you are told otherwise.

Regular exercise should improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.