October 1999

Recent advances in echocardiographic instrumentation have increased the diagnostic capabilities of TEE, but have also increased the number of possible approaches for performing a routine TEE examination. Guidelines recommending a methodology for performing a comprehensive intraoperative multiplane TEE examination based on a series of 20 anatomically referenced cross-sectional images are described to promote training in TEE, assist assessment of quality and completeness of individual studies,and facilitate comparison of studies performed at different centers.When possible, the cross-sectional imaging planes were chosen to correspond to those used in transthoracic echocardiography, and an effort was made to choose nomenclature consistent with the recommendations of the ASE Committee on Nomenclature and Standards. We hope that acceptance of a format for performing, acquiring, and archiving intraoperative multiplane TEE examinations will promote a more objective approach to describing the echocardiographic findings that are used to make management decisions and increase the benefit that can be achieved with TEE in the operating room.