Efficacy of Transesophageal Echocardiography for Diagnosis and Surgical Treatment of Severe Acute Pulmonary Embolism

Abstract

We report the efficacy of transesophageal echocardiography (TEE) in the diagnosis of severe, acute pulmonary embolism (APE). In ten cases, TEE was performed early after the occurrence of APE. In nine of the ten cases, transthoracic echocardiography (TTE) revealed distention of the right ventricle. In eight cases, TEE detected thrombus in the pulmonary artery. In cases with thrombus in the central pulmonary artery, the findings using TEE were almost same as those using chest computed tomography or pulmonary arteriography, or surgical findings. In six cases, thrombolytic and anti-coagulant therapy were given. Surgery was performed in four patients. One patient who received thrombolytic and anticoagulant therapy died. We conclude that TEE is a useful diagnostic tool for severe APE and, in cases with circulatory collapse, if TEE reveals thrombus in the pulmonary artery, surgery is indicated without the need for further diagnostic study.