Trans-oesophageal echocardiography (TOE)
What is trans-oesophageal echocardiography (TOE)?
Trans-oesophageal echocardiography (TOE) is a procedure performed under sedation to obtain detailed images of the heart with high frequency ultrasound.
The procedure involves the insertion of an ultrasound probe into the oesophagus.
Your oxygen saturation and blood pressure are carefully monitored until you are fully alert. Swallowing is then supervised before discharge.
Why is a trans-oesophageal echocardiography (TOE) performed?
A trans-oesophageal echocardiography (TOE) is usually used to help assess a problem with a heart valve and to show if it is possible to repair or replace that valve.
It is also used to help guide a heart specialist during a procedure to close holes between heart chambers or to insert devices.
If you need a controlled electric shock to treat an abnormal heart rhythm (cardioversion), a trans-oesophageal echocardiography (TOE) is sometimes used first to check if you have a blood clot in any of your heart chambers.
How long does a trans-oesophageal echocardiography (TOE) procedure take?
A trans-oesophageal echocardiography (TOE) procedure usually takes about 30 minutes.
How long will I be at the clinic for?
You will be admitted to the clinic on the morning of your procedure. Following your procedure, you will be required to stay two to three hours. If you are having a cardioversion as well you will be required to stay for four hours.
How do I prepare for a trans-oesophageal echocardiography (TOE) procedure?
Provide informed consent
Your doctor will explain your procedure to you and answer any questions you may have. You will then be asked to sign a consent form.
You will find a copy of the consent form below. Please download and read this document in advance of your visit. Your doctor will discuss this with you on your arrival, if they have not already done so.
Consent for Transoesophageal Echo (TOE) and Elective DC Cardioversion
If you have any questions or concerns, or require any additional information about your procedure in advance of your visit, please let your doctor know.
If you have access to a printer, then please print your consent form and bring it with you on the day of your procedure. Otherwise we will provide you with a copy on the day to sign with your doctor.
If you have already signed the consent in your doctor’s rooms, then please disregard this instruction.
Contact us the day before your procedure
Please ring us between 12 noon and 3pm on the day before your procedure [tel: 02 9382 0700] to confirm your time of arrival, fasting and medication instructions. Please ring on a Friday if your procedure is on a Monday.
If you have special needs (these are outlined in the Before my visit patient guide) please let us know one week in advance of your visit.
All patients attending Eastern Heart Clinic are fasted prior to their procedure. Please follow the fasting instructions that are given to you when you ring us the day prior to your procedure.
- All patients must cease solid food six hours before their admission time
- All patients must cease clear fluids two hours before their admission time (note: clear fluids are NOT cloudy or milky drinks)
- From two hours before your admission – nil by mouth
For example, if your admission time is 7:00 am (please tailor this to your admission time)
- You can eat food up until 1:00 am
- You can have clear fluids (water, black tea/coffee, clear juice etc) up until 5:00 am
We will confirm the time of your procedure and when you need to start fasting when you call the clinic the day before your procedure (please refer to our detailed instructions in the Before my visit patient guide).
Patients prescribed Warfarin
If you take the medication Warfarin you will need to consult with your referring cardiologist who will advise you if you need to stop taking your Warfarin three days before your procedure. Your cardiologist may also advise that you need to take a substitute anticoagulant (blood thinner). It is very important that you do not stop taking your Warfarin until you have discussed this with your cardiologist.
Patients prescribed Lasix
On the day of your procedure:
If your procedure is scheduled for before 12:00 pm: Withhold your Lasix and bring in your tablets so staff can give them to you after your procedure
If your procedure is scheduled for after 12:00 pm: you may take your Lasix
Patients with diabetes
If you are prescribed insulin we suggest you take half your regular insulin dose on the day of your procedure. Remind the booking staff that you are on insulin and we will attempt to schedule your procedure as early as possible.
Insulin dependent (IDDM): You should take half (½) of your regular insulin dose (please bring in insulin)
Non-insulin dependent (NIDDM) – tablet controlled: You should continue your medication as normal
Non-insulin dependent (NIDDM) – diet controlled: Fast as per the instructions above
Oral Sodium Glucose Inhibitors
If you take any of the following medication – Forxiga, Xigduo, Qtern, Jardiance, Jardiamet, Glyxambi, Steglatro, Segluromet, Steglujan – please contact Eastern Heart Clinic for instructions prior to your procedure.
Aspirin, Plavix, Prasugrel, Ticagrelor, Pradaxa, Apixaban, Rivaroxaban
Your cardiologist will provide advice regarding if and when to stop other medication. All other medications include Aspirin, Plavix, Prasugrel, Ticagrelor, Pradaxa, Apixaban, Rivaroxaban.
We will discuss your medications with you when you call the clinic the day before your procedure (please refer to our detailed instructions in the Before my visit patient guide).
Skin and nails
There are no special requirements before your procedure in terms of skin care, so just shower or bath as usual. However, please do not wear nail polish to your appointment.
What to bring
Please bring your current medications as well as any blood results. Please read our patient guide Before my visit for other items to bring with you on the day, and for how to prepare for your procedure.
Can I drive (or fly) afterwards?
You are advised not to drive or fly for 24 hours after your procedure. Please arrange for someone to drive you home if travelling by car, or to accompany you if you are travelling by taxi or Uber.
Please note that some airlines place restrictions on patients flying after certain procedures. Our staff will be able to provide you with guidance and advice.
What if I have questions or concerns?
If you have any questions about your forthcoming procedure, please contact your referring cardiologist or Eastern Heart Clinic on tel: 02 9382 0700.
What will happen before, during and after my procedure?
For a detailed overview of how to prepare for your procedure and what to expect before, during and after your visit to Eastern Heart Clinic, please read the following patient guides: