Transnasal transesophageal echocardiography in the detection of left atrial thrombus

J Cardiol. 2009 Dec;54(3):425-31. doi: 10.1016/j.jjcc.2009.07.002. Epub 2009 Nov 3.

Abstract

Background: The widespread use of transesophageal echocardiography (TEE) is limited by disadvantages, including patient intolerance and increased medical costs. We aimed to investigate the feasibility and safety of transnasal TEE in the detection of possible embolic sources in patients with atrial fibrillation (AF) and/or stroke, using an ultrathin TEE probe.

Methods: Sixty-two patients with AF and/or stroke underwent transnasal TEE without conscious sedation. The presence or the absence of the following parameters was evaluated: left atrial (LA) thrombus; LA spontaneous echocardiographic contrast; intraatrial shunts; and aortic plaque.

Results: The insertion of a TEE probe was successful in 52 (84%) patients. TEE found LA thrombus in 10 (19%) patients and other embolic sources in 4 (8%) patients. Two (4%) patients had mild epistaxis.

Conclusions: This study demonstrated that the use of transnasal TEE was feasible and safe in the detection of LA thrombus in patients with AF and/or stroke.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / complications*
  • Coronary Thrombosis / diagnostic imaging*
  • Coronary Thrombosis / etiology
  • Echocardiography, Transesophageal / instrumentation
  • Echocardiography, Transesophageal / methods*
  • Feasibility Studies
  • Female
  • Heart Atria / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Nasal Cavity*
  • Risk
  • Stroke / etiology