Impact of Perioperative Transesophageal Echocardiography in Aortic Valve Replacement

Qizilbash, Baqir; Couture, Pierre; Denault, André

doi:10.1177/1089253207311789

Cited by 7 publications

(4 citation statements)

References 48 publications

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“…Numerous studies have shown that modifications in therapy occur from 10% to more than 40% of cases. [7] The impact of TEE can be divided among modifications of therapy before, during, and after cardiopulmonary bypass. Before cardiopulmonary bypass, TEE can provide prognostic information, optimize hemodynamics, and diagnose conditions that were not appreciated before surgery, including patient-prosthesis mismatch.…”

Section: Resultsmentioning

confidence: 99%

Quantification of AS and AR

Mehta

Singh

2009

Ann Card Anaesth

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Trans-esophageal echocardiography (TEE) is routinely used in valvular surgery in most institutions. The popularity of TEE stems from the fact that it can supplement or confirm information gained from other methods of evaluation or make completely independent diagnoses. Quantitative and qualitative assessment permits informed decisions regarding surgical intervention, type of intervention, correction of inadequate surgical repair and re-operation for complications. This review summarizes the various methods for quantification of aortic regurgitation and stenosis on TEE. The application of Doppler echo (pulsed wave, continuous wave and color) with two-dimensional echo allows the complete evaluation of AV lesions.

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Section: Resultsmentioning

confidence: 99%

Quantification of AS and AR

Mehta

Singh

2009

Ann Card Anaesth

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“…Additional imaging modalities that can be utilized preoperatively include transesophageal echocardiogram (TEE) and transthoracic echocardiogram (TTE). Echocardiography has the ability to provide critical information in order to optimize hemodynamics and identify conditions that had not been appreciated on static imaging [8]. In regard to determining which form of echocardiography (TEE vs. TTE) is most appropriate, several factors should be considered.…”

Section: Preoperative Imagingmentioning

confidence: 99%

Cannulation for Cardiopulmonary Bypass

Bond¹,

Valadon²,

Slaughter³

2020

Cardiac Surgery Procedures

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Cardiac surgery has made significant progress since the advent of cardiopulmonary bypass. Arterial cannulation for bypass is a cornerstone to most cardiac procedures. Choosing an ideal cannulation site, employing peri-and intraoperative imaging, selecting an appropriate cannula, and avoiding complications are vital to success. These, along with the steps to arterial cannulation, are discussed in this chapter.

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“…Although routine valve replacement is considered a category II indication, TOE provides information that can guide modifications of anaesthetic and surgical care which lead to improved outcome. (57) Use of TOE during more complex valve replacement like stentless aortic valve or homograft is invaluable and classed as category I. (33) These prostheses require surgical experience and accurate intra-operative TOE analysis such as precise diameter measurements of the aortic root and ascending aorta as well as the origin of the coronary ostia.…”

Section: Peri-operative Toementioning

confidence: 99%

The role of peri-operative transoesophageal echocardiography

Swanevelder

2017

SAHJ

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The role of peri-operative transoesophageal echocardiography cardiovascular surgery. (5,6,7,8,9,10) More recent retrospective analyses of prospectively collected data suggest that around 5.6% of surgical procedures are altered on the basis of intra-operative echocardiographic findings and that there are cost-benefit savings particularly during combined valve and graft operations. (11,12,13) Recently, the roles for peri-operative echocardiography have also extended to include intensive care (14,15) and non-cardiac surgery. (16,17,18) Although it is complex to scientifically prove the benefits of a diagnostic monitor, TOE has been shown to strongly influence intra-operative anaesthetic decisions, particularly in patients with increased risk factors for haemodynamic instability or myocardial ischaemia. In a prospective observational case series of 98 patients undergoing abdominal surgery, the judgement of the anaesthetists was that TOE led to useful alterations in intraoperative care such as administration of fluids, vasoactive drugs and β blockers. In some patients, use of the pulmonary artery catheter was obviated. (19) Similarly, in another case series comprising 90 patients undergoing vascular, visceral and chest surgery, TOE directed changes in drug (47%) and fluid therapy (24%). PERI-OPERATIVE TOE IntroductIonIn 1976 transoesophageal echocardiography (TOE) was introduced into clinical practice.(1) Within a decade, its use extended from cardiology departments into the cardiac surgical arena. However,at that time few probes were available for the operating theatre.Indeed in a report from the United States in 1988, only about 50 TOE probes were accessible for intra-operative use.(2) Furthermore, despite its utility for cardiac surgery, it became evident that few cardiologists were able to spend long periods in the operating theatre. Over time much enthusiasm and expertise for TOE has developed amongst cardiac anaesthesiologists, and by 2001, 94%of respondents in a survey of the Society of CardiovascularAnaesthesiologists utilised intra-operative echocardiography in their routine practice.Over the past 30 years technology has improved tremendously and intra-operative TOE has become an established imaging modality and the gold standard intra-operative cardiac monitor and diagnostic tool in certain cardiac procedures, e.g. mitral valve repair, congenital heart surgery, etc. IndIcAtIons And PrActIcE guIdElInEsEarly experience with the use of peri-operative echocardiography was obtained from its application in cardiac anaesthetic practice; recently however, its role has extended to include non-cardiac surgery and intensive care. Category I indications are supported by strong evidence and expert opinion that TOE is indicated, very useful and will improve patient outcome. These category I indications encompass the everyday practice of the intra-operative anaesthetist-echocardiographer and will be discussed in more detail in this review.Category II indications are supported by weaker evidence and less expert opinion ...

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Impact of Perioperative Transesophageal Echocardiography in Aortic Valve Replacement

Cited by 7 publications

References 48 publications

Quantification of AS and AR

Quantification of AS and AR

Cannulation for Cardiopulmonary Bypass

The role of peri-operative transoesophageal echocardiography

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