Practice guidelines for perioperative transesophageal echocardiography: Recommendations of the Indian association of cardiovascular thoracic anesthesiologists

Abstract

Transoesophageal Echocardiography (TEE) is now an integral part of practice of cardiac anaesthesiology. Advances in instrumentation and the information that can be obtained from the TEE examination has proceeded at a breath-taking pace since the introduction of this technology in the early 1980s. Recognizing the importance of TEE in the management of surgical patients, the American Societies of Anesthesiologists (ASA) and the Society of Cardiac Anesthesiologists, USA (SCA) published practice guidelines for the clinical application of perioperative TEE in 1996. On a similar pattern, Indian Association of Cardiac Anaesthesiologists (IACTA) has taken the task of putting forth guidelines for transesophageal echocardiography (TEE) to standardize practice across the country. This review assesses the risks and benefits of TEE for several indications or clinical scenarios. The indications for this review were drawn from common applications or anticipated uses as well as current clinical practice guidelines published by various society practicing Cardiac Anaesthesia and cardiology . Based on the input received, it was determined that the most important parts of the TEE examination could be displayed in a set of 20 cross sectional imaging planes. These 20 cross sections would provide also the format for digital acquisition and storage of a comprehensive TEE examination. Because variability exists in the precise anatomic orientation between the heart and the esophagus in individual patients, an attempt was made to provide specific criteria based on identifiable anatomic landmarks to improve the reproducibility and consistency of image acquisition for each of the standard cross sections.

A lethal tension pneumothorax during minimally invasive coronary artery bypass surgery: Can transesophageal echocardiography pick it?

“…TEE showed a mass effect on the right atrium which was immediately notified to operating surgeon. [ 4 ]…”

Role of transoesophageal echocardiography in renal cell carcinoma: a brief review

“…Postinduction, TOE (lower oesophageal hepatic venous view) ruled out the intracardiac extension (see online Supplementary file 3). The lower oesophageal hepatic venous view is obtained at the angle of 20°, while the TOE probe is rotated towards right 5. Surgery commenced with laparotomy, and the urologist mobilised the right kidney.…”

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“…In contrast with the aortic valve, the cusps of the pulmonic valve are supported by freestanding musculature with no direct relationship with the muscular septum; its cusps are much thinner and lack any fibrous continuity with the anterior leaflet of the TV. [56]…”