Transesophageal Echocardiography Interpretation: A Comparative Analysis Between Cardiac Anesthesiologists and Primary Echocardiographers

Abstract

Interpretation of intraoperative transesophageal echocardiograms can be reliably performed by cardiac anesthesiologists.

Comprehensive Quality Improvement Program for Intraoperative Transesophageal Echocardiography: Development, Implementation, and Initial Experience

“…10 Recognizing the need for a more robust approach to perioperative TEE QI to minimize medical errors and justify physicians' payment for services, the SCA and the American Society of Echocardiography formed a task force to implement quality assurance and accreditation in perioperative echocardiography in partnership with the Intersocietal Accreditation Commission (IAC). 1 Previous reports have been limited to incorporate some of the quality domains evaluated in the authors' program, including image acquisition, 3 completeness of the study, 2,3,11 image interpretation, 2,12,13 and completeness of documentation. 3 In delineating their program, the authors applied the most recent guidelines on QI in echocardiography.…”

“…In the authors' program, a group of internal reviewers, who were selected from a team of cardiothoracic anesthesiologists, were incorporated versus relying on external expertise provided by cardiologists or radiologists. 2,3,12 The cardiac anesthesiologists at the authors' institution are board certified in advanced perioperative TEE by the National Board of Echocardiography. Anesthesiologists who had performed the greatest number of TEE studies were selected to join the group of reviewers (4 in total).…”

Role of Perioperative Echocardiography Leadership in a Tertiary University Hospital

“…Any discrepancy in interpretation should be reported back to the echocardiographer and evidence suggests that this feedback process helps in quality improvement. 24,25 Currently, recertification examination in PTE has to be taken by the practicing echocardiographers every 10 years to maintain their certification.…”

Current State of Intraoperative Echocardiography

“…Only a few studies have compared the interpretations of intraoperative TEE by cardiologists and anesthesiologists. Based on 154 patients, Mathew et al 7 reported that agreement between anesthesiologists and cardiologists was reached in 80% of the studies, and experienced anesthesiologists (over 5 years of experience) had higher levels of accuracy. Miller et al 8 demonstrated that anesthesiologists correctly interpreted 79% of baseline images, whereas 6% were interpreted incorrectly and 15% were not evaluated.…”