Intra-arrest transesophageal echocardiography during cardiopulmonary resuscitation

Abstract

Determining the cause of cardiac arrest (CA) and the heart status during CA is crucial for its treatment.Transesophageal echocardiography (TEE) is an imaging method that facilitates close observation of the heart without interfering with cardiopulmonary resuscitation (CPR). Intra-arrest TEE is a point-of-care ultrasound technique that is used during CPR. Intra-arrest TEE is performed to diagnose the cause of CA, determine the presence of cardiac contraction, evaluate the quality of CPR, assist with catheter insertion, and explore the mechanism of blood flow during CPR. The common causes of CA diagnosed using intra-arrest TEE include cardiac tamponade, aortic dissection, pulmonary embolism, and intracardiac thrombus, which can be observed on a few simple image planes at the mid-esophageal and upper esophageal positions. To operate an intra-arrest TEE program, it is necessary to secure a physician who is capable of performing TEE, provide appropriate training, establish implementation protocols, and prepare a plan in collaboration with the CPR team.

Detection of left main coronary trunk occlusion due to prosthetic aortic valve endocarditis using transoesophageal echocardiography

“…Kim et al reported that TEE could be useful for evaluating the LMT pathology in cases of severe intraoperative hypotension caused by acute occlusion of the left main coronary ostium by mobile vegetation 4. Compared with transthoracic echocardiogram, TEE provides excellent echocardiographic windows to the heart regardless of the patient’s body type5; furthermore, it has a high accuracy and can provide further details regarding thrombus and vegetation 6…”