# Esophageal Contrast Transesophageal Echocardiography for Mitral Valve Transcatheter Edge-to-Edge Repair in Severe Esophageal Achalasia

## TL;DR

A new TEE technique called ECTE allows for better imaging during heart valve repair in patients with severe esophageal achalasia.

## Contribution

The novel ECTE technique enables high-quality imaging for cardiac procedures in patients with severe esophageal conditions.

## Key findings

- ECTE improved probe positioning and imaging quality in a patient with severe achalasia.
- The technique allowed successful procedural guidance for mitral valve repair.
- ECTE overcomes challenges posed by esophageal pathologies during TEE.

## Abstract

Severe esophageal achalasia complicates transesophageal echocardiography (TEE), particularly in patients requiring mitral valve transcatheter edge-to-edge repair. We developed an innovative imaging technique called esophageal contrast TEE (ECTE), specifically designed for optimal imaging in complex conditions.

An 80-year-old man with chronic atrial fibrillation and severe mitral regurgitation was referred for mitral transcatheter valve edge-to-edge repair. His severe achalasia with esophageal dilation was challenging for adequate TEE because of poor probe-mucosa contact. Using ECTE, we optimized the probe position and enabled high-quality procedural guidance.

ECTE can overcome imaging barriers in severe esophageal pathologies and enable safe and effective cardiac interventions.