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Canadian Journal of Anaesthesia

, Volume 43, Issue 3, pp 278–294 | Cite as

An introduction to transoesophageal echocardiography: II. clinical applications

  • Donald Oxorn
  • Gerald Edelist
  • Mark Stafford Smith
Equipment in Anaesthesia

Abstract

Purpose

As progress has been made in the acquisition of cardiac images with transoesophageal echocardiography, the technique has moved from the confines of the cardiology laboratory into the operating room, the intensive care unit, and the emergency department. This has afforded anaesthetists the opportunity to become familiar with, and develop expertise in its practice. The purpose of this article is to present a review of transoesophageal echocardiography with reference to anaesthetic practice.

Source

The principle source of material was a computerized Medline™ search of the English language literature from 1986 to 1995.

Principle findings

After discussing the technique of probe insertion, and describing some of the standard images, transoesophageal echocardiography’s clinical utility is critically assessed. Comparisons with available monitoring techniques are made with reference to ventricular function, valvular heart disease, pericardial, aortic and congenital heart disease, and the management of the multiple traumatized patient. Issues of certification and maintenance of competence are also discussed.

Conclusion

Although the benefit of transoesophageal echocardiography is intuitive in many clinical situations, in others, it has not been shown to improve upon presently existing monitoring techniques. The need for adequate training and collaboration with cardiology colleagues is emphasized.

Key words

anaesthesia: cardiac arteries: aorta complications: trauma equipment: Doppler, echocardiography heart: echocardiography, transoesophageal, myocardial function heart valves pericardium, congenital defects measurement techniques: echocardiography 

List of abbreviations

TEE

transoesophageal echocardiography

LA

left atrium

MV

mitral valve

LV

left ventricle

LVOT

left ventricular outflow tract

AV

aortic valve

RV

right ventricle

RA

right atrium

IAS

interatrial septum

TV

tricuspid valve

IVS

interventricular septum

PA

pulmonary artery

PCWP

pulmonary capillary wedge pressure

EDA

end diastolic area

ESA

end systolic area

TTE

transthoracic echocardiography

SWMA

segmental wall motion abnormality

HOCM

hypertrophic obstructive cardiomyopathy

SAM

systolic anterior motion

IE

infective endocarditis

ASE

American Society of Echocardiography

ASA

American Society of Anesthesiologists

SCA

Society of Cardiovascular Anesthesiologists

Résumé

Objectif

Tout en progressant sur le plan technique, l’échographie transoesophagienne a débordé le cadre du laboratoire de cardiologie pour atteindre celui de la salle d’opération, de l’unité de soins intensifs et de la salle d’urgence. Il a été alors possible pour l’anesthésiste de se familiariser avec la technique et d’accroître sa compétence. L’objectif de ce travail est de présenter une perspective de l’échographie transoesophagienne appliquée au domaine de l’anesthésie.

Source

La source principale de cette revue est une recherche par ordinateur sur Medline™ des publications en anglais de 1986 à 1995.

Données principales

Après discussion de l’insertion de la sonde et la description d’images standard, l’utilité de l’échographie transoesophagienne est évaluée. Des comparaisons avec les techniques de monitorage de la fonction ventriculaire en usage sont établies en ce qui concerne la cardiopathie valvulaire, les maladies péricardiques, aortiques et les cardiopathie congénitales ainsi que la gestion du polytraumatisé. Les probème de la certification et du maintien de la compétence sont aussi discutés.

Conclusions

Bien que les bénéfice de l’échographie transoesophagienne se rapproche de l’intuition dans plusieurs situations, dans d’autres, on n’a pas montré sa supériorité sur les autres techniques de monitorage actuelles. La nécessité d’une formation appropriée et la collaboration avec les collègues cardiologues sont soulignées.

Bibliography

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Copyright information

© Canadian Anesthesiologists 1996

Authors and Affiliations

  • Donald Oxorn
    • 1
    • 2
  • Gerald Edelist
    • 1
  • Mark Stafford Smith
    • 3
  1. 1.Department of AnaesthesiaSunnybrook Health Science Centre, University of TorontoToronto
  2. 2.Division of CardiologySunnybrook Health Science Centre, University of TorontoToronto
  3. 3.Department of AnaesthesiaQueen Elizabeth II Health Sciences Centre, Dalhousie UniversityHalifax

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