An update on intraoperative three-dimensional transesophageal echocardiography

Clinical cardiac ultrasound emerged after World War II, discovered with the help of naval sonar technology. Initially, images consisted of a single ultrasound vector of ultrasound displayed over time—“M-Mode” imaging (1). Over the next several years, technological advances over the next several years allowed for the introduction of 2D (1970s) and 3D (1990s) imaging into clinical practice. Transesophageal echocardiography (TEE) developed in 1970s overcame the limitations of transthoracic echocardiographic (TTE) images (2). Notably, in 1980, TEE became standard practice for the first time in cardiac operating rooms to facilitate surgical decision-making (1). In the 1990s, the first 3D images of the mitral valve (MV) were created using the rotational scan plane technology during post processing, However, this was limited by difficult acquisition methods and cumbersome analysis software (2). The advent of matrix transducers made the clinical use of 3D TEE possible. Real-time three-dimensional (RT-3D) TEE became widely used intraoperatively and second and third generation advancements in TEE transducers allowed for increased spatial and temporal resolution. With faster processing and quantification. RT-3D TEE has become a simple and quick imaging modality, increasingly practiced by experienced echocardiographers