Impact of Perioperative Transesophageal Echocardiography on Cardiac Surgery

Abstract

Transesophageal echocardiography (TEE) is recognized as a semi-invasive technique with increasing impact on diagnostic tools in cardiac surgery. Particularly, TEE plays a role in patients undergoing cardiac valve repair or congenital heart surgery with regard to the assessment of the operative success. Other proven roles of TEE are in evaluating atheromatous disease of the aortic arch, detection of aortic dissection and aneurysm, and diagnosis of pathologic findings within the heart and the pericardial sac. The power of TEE in diagnosis and decision making may lead to an improved clinical outcome which in turn may lead to a reduction in financial efforts.

Challenges Regarding the Value of Routine Perioperative Transesophageal Echocardiography in Mitral Valve Surgery

“…Additionally, the utility of immediate postoperative TEE in the ICU for suspected pericardial or pleural collections or assessing residual MR after valvuloplasty is not outlined in guidelines due to low occurrence rates and higher experience levels in mitral valvuloplasty in other countries, where TEE is extensively used intraoperatively. Moreover, routine evaluation of MV prostheses after CPB is presented as a relative indication in the literature but showed limited benefit in our study, possibly due to extensive experience with valve replacement in our country, leading to selective TEE utilization for suspected prosthesis dysfunction [ 27 , 28 , 29 ].…”

Clinical Outcomes after Hybrid Coronary Revascularization versus Off-Pump Coronary Artery Bypass

“…But this single event within the first 30 days should not retract significantly from the overall safety of a staged approach with close observation in the hospital while awaiting the second stage. The high degree of safety of the endo-ACAB operation in the setting of three-vessel CAD may be attributed to advances in cardiac anesthesia, the judicious use of intraoperative transesophageal echocardiography, 32 which provides early warning signs of ischemia, and the simple fact that endoscopic CABG procedures involving a single graft to the LAD rarely requires any cardiac displacement, in contrast to OPCAB surgery. Despite these observations, the responsibility remains with the surgeon and cardiologist to assess whether the patient will likely remain stable immediately after the LIMA grafting and until such time as the non-LAD lesions can be treated.…”

Role of transesophageal echocardiography in the management of pediatric patients with congenital heart disease

“…Over the past two decades, transesophageal echocardiography (TEE) has solidified its role as a critical diagnostic and perioperative management tool for patients with congenital heart disease (CHD). TEE has proven to be invaluable in confirming preoperative diagnoses, formulating surgical plans, evaluating immediate operative results, identifying patients with residual defects, and guiding surgical revisions (1–8). Technological advancements, particularly the use of small probe sizes, have significantly improved patient safety and success of cardiac surgery in infants and children (9–20).…”