TOE

TOE

TOE the short form name for trans-oesophageal echocardiogram (or echo). TOE is a procedure which uses a flexible telescope placed down your oesophagus (food pipe) to examine the chambers and valves of your heart. The telescope has an ultrasound scanner attached to it so your doctor can get close-up views of your heart. TOE enables your doctor to obtain important structural and functional information of your heart, such as problems with heart valves. A TOE is also used to help guide the heart specialist during procedures to close holes between heart chambers or insert devices.

What happens during the TOE procedure?

TOE is a day procedure at a hospital. 

At the start of the procedure, the back of your throat will be sprayed with a local anaesthetic, which causes the area to become numb — much the same feeling as you would experience at the dentist. An anaesthetist will be present to give intravenous relaxing medication. You will be fitted with a mouthguard to stop you biting on the TOE probe. Should you have dentures these will temporarily be removed.
After you are relaxed the TOE probe is placed gently into your mouth, over the tongue into the back of the throat and at this point you will be asked to swallow.  An effective swallow will have the probe in the correct position to pass down your oesophagus (food pipe) to the area close to your heart.

When the probe is in the right place, pictures of your heart are taken. The probe will be in place for about 15 minutes. 

Do not be concerned if you experience excess saliva ‘dribbling’ while the probe is down your throat.

Protective sheets will be in place and suction will be provided where necessary. During the TOE procedure, your pulse, blood pressure and electrocardiogram (ECG) will be monitored. If your heart specialist is worried about these, the test will be stopped.

Due to the small dose of relaxant given during the test, you will be observed for a short time after the test and then allowed to go home accompanied by another adult.

Preparing for the TOE procedure

You must fast for at least 6 hours prior to the test. You may take your usual medications with a sip of water, unless you are instructed to do otherwise.  If you are taking diabetic medication, you must let the doctor know as you will be given special instructions.

What are the risks associated with the TOE procedure?

You should not experience any significant side-effects following this test. Minor complications include sore throat, bleeding or dental damage or injury. Some more serious complications may include allergic reaction to anaesthetic, breathing difficulties or heart irregularities, trauma to the oesophagus or stomach (including perforation). On very rare occasion, there may be a chance of a 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