ESCEuropean Heart Journal-Cardiovascular Imaging(2023)00,1-79EACVI DOCUMENTEuropean Society https://doiorg/10.1093/ehjci/jead90of CardiologyThree-dimensional transoesophagealechocardiography:how to use and when touse-a clinical consensus statement from theEuropean Association of Cardiovascular Imagingof the European Society of CardiologyFrancesco F.Faletra*,Eustachio Agricola Frank A.Flachskampf,Rebecca Hahn,Mauro Pepi,Nina Ajmone Marsan,Nina Wunderlich,Leyla Elif Sade,Erwan DonalJose-Luis Zamorano,Bernard Cosyns,Mani Vannan,Thor EdvardsenAlain Berrebi,Bogdan A.Popescu,Patrizio Lancellotti and Roberto LangReviewers:This document was reviewed by members of the 2020-2022 EACVI Scientific DocumentsCommittee:Magnus Back,Philippe B.Bertrand,Marc Dweck,Niall Keenan,and Ivan StankovicDivision of Cardiology.ISMETT:Istituto Mediterraneo peri Trapianti e Terapie ad Alta Specializzazione Palemmo,Lugano 6900.SwitzerlandRecelved 7 April 2023:accepted 11 Aprl 2023Three-dimensional transoesophageal echocardiography (3D TOE)has been rapidly developed in the last 15 years.Currently,3D TOE is particularlyuseful as an additional imaging modality for the cardiac echocardiographers in the echo-lab,for cardiac interventionalists as a tool to guide complexcatheter-based procedures cardiac,for surgeons to plan surgical strategies,and for cardiac anaesthesiologists and/or cardiologists,to assess intra-operative results.The authors of this document believe that acquiring 3D data set should become a'standard part'of the TOE examination.Thisdocument provides(i)a basic understanding of the physic of 3D TOE technology which enables the echocardiographer to obtain new skills neces-sary to acquire,manipulate,and interpret 3D data sets,(ii)a description of valvular pathologies,and (ii)a description of non-valvular pathologies inwhich 3D TOE has shown to be a diagnostic tool particularly valuable.This document has a new format:instead of figures randomly positionedthrough the text,it has been organized in tables which incude figures.We believe that this arrangement makes easier the lecture by clinical cardiol-ogists and practising echocardiographers.7512Keywordstransoesophageal three-dimensional echocardiography basic physical principle of 3D TOE.3D TOE in valvularpathologies.3D TOE in non-valvular pathologiesIntroduction and scopetransthoracic echocardiography (TTE).2D TOE has the followingadvantages:Two-dimensional multiplane transoesophageal echocardiography2023(2D TOE)is a well-established ultrasound technology which is ex-tensively used in clinical practice,during percutaneous catheter-(a)Distortion of ultrasound beams crossing the thin muscular tissue andbased procedures and in the operating room.Compared withthe squamous epithelium of the oesophageal wall is negligible.Corresponding author.E-mail francesco.faletra@gmaicomThe Author(s)2023.Published byOxfordUniversity Press onbehalf of the European Societyof Cardology.All rights reserved For permissions.please e-mail jourma
