Ask Dr. Z

Can you provide some tips/guidance on how to distinguish a diagnostic TEE from TEE monitoring when a surgeon provides TEE findings during a cardiac procedure such as a CABG/valve replacement? I will often see surgeons provide baseline TEE findings (e.g., after opening the chest, they note that a TEE probe was inserted either by themselves or the anesthesiologist, and the TEE reveals normal left ventricular function, no pericardial effusion, and severe mitral regurgitation). In this example, if the patient came to the OR for a planned mitral valve replacement due to mitral regurgitation, and all I had were those findings, I would think this is just a baseline/confirmatory study that is part of TEE monitoring (they will use the TEE again after valve replacement to ensure resolution of the regurgitation and preserved LV function). Am I correct in my assessment? In contrast, would a diagnostic TEE require a decision to intervene or a change to the plan based on the findings of the TEE (similar to an angiogram/venogram during intervention)?