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Computed tomography as an alternative to transesophageal echocardiography: A review of the literature in light of COVID-19

During the outbreak of coronavirus disease 2019 (COVID-19) in the spring of 2020, the CDC recommended health-care providers limit performing aerosol-producing procedures when possible. Transesophageal echocardiography (TEE) is a procedure used frequently for both procedural and nonprocedural cardiac imaging. The performance of a TEE requires not only for physicians and staff to be physically close to the mouths of potentially infected patients, but also involves aerosol generating activities such as airway suctioning. In addition, intubation with TEE probe can cause coughing. Cardiac computed tomography (CT) is an imaging modality that does not increase COVID-19 exposure risk to cardiology staff and physicians. In this article, we review the most common indications for TEE and discuss the data supporting the viability of using cardiac CT as an alternative to TEE.