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Clinical Support - Transesophageal Echocardiography (TEE)

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Inna Shats, MA, BS, RDCS, FASE
Supervisor, TEE Service
(410) 328-0421

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The introduction of transesophageal echocardiography, also know as TEE, in the operating room represented a major advance for cardiovascular surgery. This state-of-the-art, specialized type of cardiac ultrasound allows for real-time dynamic imaging of the heart via the esophagus. We provide easily accessible information about the anatomy of the heart under physiologic conditions and are also able to demonstrate various types of pathophysiology. Currently, this modality is the standard of care for the majority of cardiac surgeries and also many non-cardiac surgeries. TEE is a powerful diagnostic tool to assist the intraoperative team in managing critically ill patients.


  • Evaluation of acute life threatening hemodynamic disturbances in which ventricular function and its determinants are uncertain and have not responded to treatment
  • Valve repair and replacement
    • Midline sternotomy
    • Minimally invasive
  • Congenital heart surgery
  • Repair of hypertrophic obstructive cardiomyopathy
  • Evaluation of endocarditis with pre-op testing is inadequate or extension of infection to perivavular tissue is suspected
  • Unstable patients with suspected thoracic aortic aneurysms, dissection, or disruption
  • Assessment of aortic valve function in repair of aortic dissections with possible valve involvement
  • Evaluation of pericardial effusion and the presence of cardiac tamponade
  • Unstable patients with unexplained hemodynamic disturbances, suspected valve disease, or thromboembolic problems
  • Assessment of repair of cardiac aneurysms
  • Evaluation of cardiac tumors
  • Placement of ventricular assist devices
  • Intra-aortic balloon pump placement
  • Total artificial heart placement (Syncardia)


  • Renal tumor excision
  • Lung transplant
  • Evaluation of ventricular function during non-cardiac cases

The TEE service utilizes many different modalities for a normal comprehensive exam. These include 2D imaging, M-mode, Doppler and color flow. Epiaortic scanning is also available to aid the surgeon with possibly difficult aortic cross-clamping.

The newest advance in intraoperative TEE is the development of Live-3D TEE. The University of Maryland TEE service is currently implementing this technology to further contribute to the intraoperative assessment of the heart.

TEE Team

Babak Ezzati
Intraoperative Cardiac Sonographer

Kristen Jordan
Intraoperative Cardiac Sonographer

Inna Shats, BS, MA, RDCS, FASE
Supervisor TEE Service
Chief Intraoperative Cardiac Sonographer