PEROPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY: CLINICAL BENEFIT DURING CARDIAC SURGERY
Keywords:
T ra n se so p h a g e a l E c h o card io g rap h y, C ard iac Surgery, P e rio p e ra tiv e b e n e fitAbstract
Objective: To evaluate the benefit of peroperative Transesophageal echocardiography (TEE) during cardiac surgery.
Design: An observational analytic study.
Place and duration of study: This study was carried out in the department of Cardiac Surgery Civil Hospital, Dow Medical College Karachi and Dow University of Health Sciences, from April 2001 to May 2007.
Subject and M ethods: In 385 patients undergoing cardiac surgery, preoperative transesophageal echocardiography was performed according to ASA guidelines.
Category 1 in which TEE considered useful, and category 11 are those where TEE is potentially useful but indications are less clear. All TEE examination was reviewed by cardiologist and anesthesiologist. For each patient, the diagnostic decision making and patient care was assessed using three criteria 1) Change in m edical therapy; 2) Change in surgical procedure; 3) C onfirm ation o f suspected diagnosis.
Results: TEE had greater utility in category 1 than in category 11 indications 17/70 (25%) versus 57/315 (18%) respectively.
Downloads
References
B raunw ald E. H eart disease: A textbook of Cardiovascular Medicine. 6 th ed. Philadelphia: W.B.
Saunders; 2001.
Fox JA, Formanek V, Friedrich A, Shernan SK. Intraoperative echocardiography. Card Surg Adult 2003;2:283-314.
Couture P, Denault AY, McKenty S, Boudreault D, Plante F, Perron R et al. Impact of routine use of intraoperative transesophageal echocardiography during cardiac surgery. Can J Anesth 2000; 47: 206 .
Ian J. Kallmeyer MB, Charles D, Collard MO, John A, Fox MD et al. The safety of intraoperative transesophageal echocardiography: A case series of 7200 cardiac surgical patients. Anesth Analg 2001; 92: 1126-30.
Fanshawe M, Ellis C, Habib S. Konstadt SN, Reich DL. A retrospective analysis of the costs and benefits related to alterations in cardiac surgery from routine intraoperative transesophageal echocardiography. Anesth Analg 2002; 95: 824-7.
. C o k is C J, F a ris J. T r a n s o e s o p h a g e a l echocardiography in routine cardiac surgery. MJA 2004; 180 : 650
Schmidlin D, Bettex D, Bernard E, German R, Torm ic M, Jenni R et al. T ranesophageal echocardiography in cardiac and vascular durgery: implications and observer variability. Br J Anaesth 2001; 86:497-505.
. Cheitlin MD, Armstrong WF, Aurigemma GP. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report o f the A m erican college of cardiology/American heart association task force on
practice guidelines (ACC/AHA/ASE Committee to update the 1997 guidelines for the clinical application of echocardiography) Circulation 2003; 108: 1146 62.
Shanewise JS, Cheung AT, Aronson S. ASE/SCA guidelines for perform ing a com prehensive in tra o p era tiv e m u ltip lan e tran se so p h a g e a l echocardiography examination: recommendations o f the Am erican Society of Echocardiography Council for Intraoperative Echocardiography and the Society of cardiovascular anesthesiologists task force for certification in perioperative transesophageal
echocardiography. Anesth Analg 1999; 89: 870-84.
Kallm eyer IJ, Collard CD, Fox JA, Body Sc, Sherm an Sk. The safety o f intraoperative transesophageal echocardiography: a case series of 7200 cardiac surgical patients. Anesth Analg. 2001; 92:1126-30.
Om ran AS, Woo A, David TE, Feinedl CM, Rakowskih, Siu SC. Intraoperative transesophageal echocardiography accurately predicts mitral valve anatom y and suitability for repair. J Am Soc Echocardiogr. 2002; 15:950-7.
Naqvi TZ, Zaky JW, Raissi SS. Transesophageal echocardiographic evaluation of perioperative systolic murmur in aortic pathology. Rev Cardiovasc Med. 2003;4:112-6.
Kodavatiganti R. Intraoperative assessment of the mitral valve by transesophageal echocardiography: an overview. Annals of Cardiac Anaesth 2002; 5: 127 34.
Mihalatos DG, Gopal AS, Kates R. Intraoperative assessm en t o f m itral reg u rg itatio n : role o f phenylephrine challenge. J Am Soc Echocardiogr. 2006; 19:1158-64.
Edrich T, Shernan SK, Smith B, Hetager K. Usefulness of intraoperative epiaortic echocardiography to resolve discrepancy between transthoracic and transesophageal measurement of aortic valve gradient - a case report. Can J Anesth 2003; 50:293-6.
M ishra M, Chauhan R, Sharma KK. Real-tim e intraoperative transesophageal echocardiography—how useful? Experience of 5,016 cases. J Cardiothorac Vasc Anesth 1998; 12:625-32.
Cahalan MK. Tranesophageal echocardiography for occasional cardiac anesthesiologist. ASA refresher courses in an esth esio lo g y 2007; 35: 31-40.
Cahalan MK, Abel M, Goldman M. American Society of Echocardiography and Society of Cardiovascular Anesthesiologists task force Guidelines for training in perioperative echocardiography. Anesth Analg 2002; 94:1384-8.
Swenson JD, Bull D, Stringham J. Subjective assessm ent o f left v en tricu lar preload using transesophageal echocardiography: corresponding pulmonary artery occlusion pressures. J Cardiothorac Vasc Anesth. 2001; 15:580-3
Russell IA, Rouine-Rapp K, Stratmann G. Congenital heart disease in the adult: a review with internetaccessible transesophageal echocardiographic images. Anesth Analg 2006; 102:694-723.
Schroder JN, Williams ML, Hata JA . Impact of mitral valve regurgitation evaluated by intraoperative transesophageal echocardiography on long-term outcomes after coronary artery bypass grafting. Circulation 2005; 112:I293-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Sadqa Aftab, Shams Rashdi, Abdul Bari, Mudassir Iqbal Darr, Aftab Mehtab
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. 
