# Trans Nasal Transesophageal Echocardiography

> **NIH NIH R61** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2024 · $385,000

## Abstract

Project Summary:
 Transesophageal echocardiography (TEE) is an essential diagnostic tool in cardiology. There are over one
million TEEs performed annually in the United States. A major advantage of TEE over transthoracic echo
(TTE) is superior resolution of posterior structures such as the mitral valve and the left atrial appendage (LAA).
TEE also substantially reduces ultrasound scatter from the lungs, which provides better images than
transthoracic imaging, making TEE an essential imaging modality in critically ill patients. Examples of the
clinical usefulness of TEE include diagnosing and managing infectious endocarditis (infection of the valves of
the heart), diagnosing acute cardiovascular events in critically ill patients, trauma patients, and patients before
and after cardiovascular surgery.
 TEE requires the use of sedation (anesthesia). Sedation requires specialized procedural space and skilled
providers, which increases procedural cost, burdens the workflow, increases the risk to the patient, and overall
limits the availability of TEE. Sedation accounts for the majority of the harm associated with TEE including
cardiovascular (hypotension, arrythmia) and respiratory compromise. The serious risks of anesthesia are
amplified by the high prevalence of co-morbidities in patients undergoing TEE. Alternative TEE methods that
do not require anesthesia, will reduce cost, enhance workflow, expand availability, reduce risk, and in some
cases will provide more accurate information compared to conventional TEE in such cases as non-sedated
exercise mitral valve assessment, and assessment of cardiac causes of cryptogenic stroke.
 The nasal orifice is an alternative to the oral approach, and nasal-TEE can eliminate the need for sedation.
Hence, nasal-TEE represents a unique opportunity to reduce cost, improve workflow, expand availability, and
improve safety. However, prior attempts utilizing nasal-TEE systems have considerable gaps to making nasal-
TEE an effective tool over traditional TEE. Prior attempts at nasal-TEE resulted in poor image quality,
unacceptable rates of nasal bleeding, and thermal burns to the esophageal wall from overheated ultrasound
probes. Therefore, innovative strategies are needed to overcome previous limitations of nasal-TEE. We are
proposing to develop a novel, innovative nasal-TEE system to acquire high quality cardiac imaging without the
need for anesthesia.
 The overall objective of this project is to develop an innovative nasal-TEE prototype with the potential to
revolutionize cardiovascular diagnostic imaging. The proposed nasal-TEE platform will be faster, less
expensive, expand availability, safer, and in some cases provide more accurate information compared to
conventional TEE.

## Key facts

- **NIH application ID:** 10990837
- **Project number:** 1R61HL171790-01A1
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Ethan Tumarkin
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $385,000
- **Award type:** 1
- **Project period:** 2024-09-05 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10990837

## Citation

> US National Institutes of Health, RePORTER application 10990837, Trans Nasal Transesophageal Echocardiography (1R61HL171790-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10990837. Licensed CC0.

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