In fellowship, there was an cardiology attending that did a TEE on himself. So anything can be done with no general anesthesia if you try hard enough.
I don't buy it. Anyone tried to put in an OG in an awake pt knows the form factor matters very little in the pts gag and discomfort. In order to get good images, the probe has to contact the esophagus with some pressure, that along with pharyngeal stimulation will make it uncomfortable enough for >90% of the population.
"4D" TEE is just a marketing ploy. The same function existed on the Philips X8-2t for years. It's just live 3D, which could have been done on an IE-33 with X7-2t probes. 4D is nothing new.
The GE picture and processing was worse due to the physical frequency limit of the probes - Philips X8 is 8MHz while (I believe) the best probe from GE before the 9VT was only 6MHz. I'm guessing the 9VT can go up to 9MHz which will give it an edge if the processing CPU catches up. (it should be easy since the CV3D machines from Philips is barely more processing than my gaming computer during college).
The issue is market adaptation. Most institutions that uses TEE regularly have already put huge sunk costs in the Philips machines ($250k each) and probes ($40k each). Most people, myself included, trained on the Philips machines and is super used to the interface.
I consider myself pretty adaptive and open to new things. But I hate it every time I have to drive the 6VT-D with their clunky GE interface.
Sorry for the long rant: overall, nothing new. May be slightly better. But uphill battle against the established Philips market dominance.
