TEE Image Quality Improvement With Our Devised Probe Cover

Background: Transesophageal echocardiography (TEE) has become a standard intraoperative
diagnosis technique for clinical management of patients during cardiac and non-cardiac
surgery. Accurate intraoperative diagnosis by TEE improves as image quality improves.
Although we recently reported enhanced image quality using a TEE probe with an attached
orogastric tube, its clinical significance is still unknown. Also, we are concerned about
potential clinical complications including damage to the upper gastrointestinal tract due to
its rough surface. Therefore, we devised a new TEE probe cover equipped with a suction
catheter and ultrasound gel containing pad that functions as a cushion for preventing
surrounding tissue trauma. Our long-term goal is to improve TEE image quality, which will
help surgical decision-making with precise assessment. The study population will be elective
cardiac cases and liver transplant cases at Henry Ford Hospital. The objective of this grant
is to assess the image quality change with our newly designed TEE probe, and its clinical
utility on patient care in different types of procedures.

Aim 1. To assess TEE image quality before and after pin-point suctioning with our newly
designed TEE probe. We hypothesize that decreasing stomach air between the TEE probe
transducer and tissue wall by pin-point suction with our newly designed TEE probe will reduce
ultrasound reflection and lead to better image quality.

Aim 2. To evaluate the clinical utility of our newly designed TEE probe cover. We hypothesize
our newly designed TEE probe cover will facilitate decision-making for both anesthesiologists
and surgeons and it will not increase the occurrence of TEE probe related trauma.

Inclusion Criteria: OLT which had intraoperative TEE -

Exclusion Criteria: general contraindication with TEE, Inability to obtain image to measure
HVF using TEE