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Since its introduction nearly four decades ago, transesophageal echocardiography (TEE) has witnessed a remarkable evolution. The important strides made in improving TEE technology–including development of multiplane phased array transducers, matrix array transducers for three-dimensional (3D) imaging, and extensive improvements in echocardiographic imaging platform technology–have catalyzed the establishment of TEE as a critically important cardiovascular imaging modality. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 The esophageal position of the ultrasonic transducer provides superior cardiac imaging and allows monitoring of the heart before, during, and after cardiac or non-cardiac procedures without interruption.

TEE in the pediatric population became widespread after the introduction of commercially available miniaturized probes in the late 1980s. 1, 2, 3 Since then, the safety and invaluable …