Development of Biplane Transespohageal Dopper Echocardiography as a New Cardiovascular Diagnostic Method

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Color Doppler transesophageal echocardiography (TEE) is an imaging method of indispensable importance in the fields of cardiology and cardiac surgery. However, in the present state of the art there is a major limitation in TEE technology : only a transverse view can be obtained with the single-transducer TEE probe. In 1989 (the first year), in order to further improve the TEE technique we newly developed and tested clinically a biplane probe. To the best of our knowledge we are the first where a new biplane probe was used clinically. The biplane probe is 13.5 mm in diameter, and transverse and longitudinal transducers are mounted side by side on the same transesophageal shaft. Either transverse or longitudinal scan can be obtained and biplane images can be reproduced side by side screen simultaneously synchronizing to ECG. The probe was successfully used both intra-and postoperatively in 260 adult cardiovascular surgical patients. The specific diagnostic value of the biplane TEE was ob … More tained firstly in mitral regurgitation and aortic dissection.In 1990 (the 2nd year), the biplane probe was used totally in 450 patients without any complication. Biplane TEE facilitated a three-dimensional understanding of cardiovascular structure and blood flow and provided new acoustic windows on the esophagus through longitudinal scanning. However, there were two major limitations in the biplane probe : (1) the two orthogonal transducers were separated and (2) biplane imaging was not real time but reproduced.In 1991 (the 3rd year), to resolve these problems, we developed a new system that combines the use of matrix biplane transducer and real-time biplane imaging software. The matrix transducer is composed of two perpendicular phased arrays for transverse and longitudinal scans. In our clinical experience in 32 patients, the real-time matrix biplane imaging system has shown various advantages over the standard biplane technique. Additionally, we designed also successfully a pediatric matrix probe. These new devices suggest a new trend in TEE technology of the future. The biplane TEE has been established as one of valuable diagnostic methods and will be a standard clinical examination in the fields of cardiolog, cardiovascular surgery, and anesthesiology. Less