Intraoperative Transesophageal Echocardiography for Thoracic Surgery

  • Massimiliano MeineriEmail author


The use of TEE outside of the cardiac operating room has significantly increased over the last few years. Thoracic surgery is naturally becoming an exciting field for the application of this powerful technology for more than one reason. In fact, in many institutions cardiac anesthetists, most of whom are TEE trained, provide their services to thoracic surgery. Moreover, the physiology of cardiopulmonary interaction, the growing number of combined cardiothoracic operations, and the increasing complexity of patients’ pathologies create the need for the complete intraoperative monitoring of cardiac function.


Thoracic surgery Intraoperative transesophageal echocardiography (TEE) TEE probe insertion TEE for lung transplant TEE for pulmonary embolectomy 

Supplementary material

Video 30.1

Case discussion. Mid-esophageal four-chamber view, zoom on mitral valve, with color Doppler (M4V 4247 kb)

Video 30.2

Case discussion. Mid-esophageal aortic valve long axis view: color Doppler of the LVOT and mitral valve (M4V 3092 kb)


  1. 1.
    Mahmood F, Christie A, Matyal R. Transesophageal echocardiography and noncardiac surgery. Semin Cardiothorac Vasc Anesth. 2008;12:265–89.PubMedCrossRefGoogle Scholar
  2. 2.
    American Society of A, Society of Cardiovascular Anesthesiologists Task Force on Transesophageal E. Practice guidelines for perioperative transesophageal echocardiography. An updated report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Anesthesiology. 2010;112:1084–96.Google Scholar
  3. 3.
    Kolev N, Brase R, Swanevelder J, et al. The influence of transoesophageal echocardiography on intra-operative decision making. A European multicentre study. European Perioperative TOE Research Group. Anaesthesia. 1998;53:767–73.PubMedCrossRefGoogle Scholar
  4. 4.
    Brandt RR, Oh JK, Abel MD, Click RL, Orszulak TA, Seward JB. Role of emergency intraoperative transesophageal echocardiography. J Am Soc Echocardiogr. 1998;11:972–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Memtsoudis SG, Rosenberger P, Loffler M, et al. The usefulness of transesophageal echocardiography during intraoperative cardiac arrest in noncardiac surgery. Anesth Analg. 2006;102:1653–7.PubMedCrossRefGoogle Scholar
  6. 6.
    van der Wouw PA, Koster RW, Delemarre BJ, de Vos R, Lampe-Schoenmaeckers AJ, Lie KI. Diagnostic accuracy of transesophageal echocardiography during cardiopulmonary resuscitation. J Am Coll Cardiol. 1997;30:780–3.PubMedCrossRefGoogle Scholar
  7. 7.
    Cahalan MK, Abel M, Goldman M, et al. American Society of Echocardiography and Society of Cardiovascular Anesthesiologists task force guidelines for training in perioperative echocardiography. Anesth Analg. 2002;94:1384–8.PubMedGoogle Scholar
  8. 8.
    Serra E, Feltracco P, Barbieri S, Forti A, Ori C. Transesophageal echocardiography during lung transplantation. Transplant Proc. 2007;39:1981–2.PubMedCrossRefGoogle Scholar
  9. 9.
    Muller-Redetzky HC, Felten M, Hellwig K, et al. Increasing the inspiratory time and I:E ratio during mechanical ventilation aggravates ventilator-induced lung injury in mice. Crit Care. 2015;19:23.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Côté G, Denault A. Transesophageal echocardiography-related complications. Can J Anaesth. 2008;55:622–47.PubMedCrossRefGoogle Scholar
  11. 11.
    El-Chami MF, Martin RP, Lerakis S. Esophageal dissection complicating transesophageal echocardiogram--the lesson to be learned: do not force the issue. J Am Soc Echocardiogr. 2006;19:579. e575–577.PubMedCrossRefGoogle Scholar
  12. 12.
    Augoustides JG, Hosalkar HH, Milas BL, Acker M, Savino JS. Upper gastrointestinal injuries related to perioperative transesophageal echocardiography: index case, literature review, classification proposal, and call for a registry. J Cardiothorac Vasc Anesth. 2006;20:379–84.PubMedCrossRefGoogle Scholar
  13. 13.
    Kallmeyer IJ, Collard CD, Fox JA, Body SC, Shernan SK. The safety of intraoperative transesophageal echocardiography: a case series of 7200 cardiac surgical patients. Anesth Analg. 2001;92:1126–30.PubMedCrossRefGoogle Scholar
  14. 14.
    Piercy M, McNicol L, Dinh DT, Story DA, Smith JA. Major complications related to the use of transesophageal echocardiography in cardiac surgery. J Cardiothorac Vasc Anesth. 2009;23:62–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2013;26:921–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Denault AY, Couture P, McKenty S, et al. Perioperative use of transesophageal echocardiography by anesthesiologists: impact in noncardiac surgery and in the intensive care unit. Can J Anaesth. 2002;49:287–93.PubMedCrossRefGoogle Scholar
  17. 17.
    Schulmeyer MC, Santelices E, Vega R, Schmied S. Impact of intraoperative transesophageal echocardiography during noncardiac surgery. J Cardiothorac Vasc Anesth. 2006;20:768–71.PubMedCrossRefGoogle Scholar
  18. 18.
    Hofer CK, Zollinger A, Rak M, et al. Therapeutic impact of intra-operative transoesophageal echocardiography during noncardiac surgery. Anaesthesia. 2004;59:3–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Comunale ME, Body SC, Ley C, et al. The concordance of intraoperative left ventricular wall-motion abnormalities and electrocardiographic S-T segment changes: association with outcome after coronary revascularization. Multicenter Study of Perioperative Ischemia (McSPI) Research Group. Anesthesiology. 1998;88:945–54.PubMedCrossRefGoogle Scholar
  20. 20.
    Eisenberg MJ, London MJ, Leung JM, et al. Monitoring for myocardial ischemia during noncardiac surgery. A technology assessment of transesophageal echocardiography and 12-lead electrocardiography. The Study of Perioperative Ischemia Research Group. JAMA. 1992;268:210–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Royse CF. Ultrasound-guided haemodynamic state assessment. Best Pract Res Clin Anaesthesiol. 2009;23:273–83.PubMedCrossRefGoogle Scholar
  22. 22.
    Kusumoto FM, Muhiudeen IA, Kuecherer HF, Cahalan MK, Schiller NB. Response of the interatrial septum to transatrial pressure gradients and its potential for predicting pulmonary capillary wedge pressure: an intraoperative study using transesophageal echocardiography in patients during mechanical ventilation. J Am Coll Cardiol. 1993;21:721–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Royse CF, Royse AG, Soeding PF, Blake DW. Shape and movement of the interatrial septum predicts change in pulmonary capillary wedge pressure. Ann Thorac Cardiovasc Surg. 2001;7:79–83.PubMedGoogle Scholar
  24. 24.
    Royse CF, Seah JL, Donelan L, Royse AG. Point of care ultrasound for basic haemodynamic assessment: novice compared with an expert operator. Anaesthesia. 2006;61:849–55.PubMedCrossRefGoogle Scholar
  25. 25.
    Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233–70.CrossRefGoogle Scholar
  26. 26.
    Della Rocca G, Costa MG, Coccia C, et al. Continuous right ventricular end-diastolic volume in comparison with left ventricular end-diastolic area. Eur J Anaesthesiol. 2009;26:272–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Scheuren K, Wente MN, Hainer C, et al. Left ventricular end-diastolic area is a measure of cardiac preload in patients with early septic shock. Eur J Anaesthesiol. 2009;26:759–65.PubMedCrossRefGoogle Scholar
  28. 28.
    Hope MD, de la Pena E, Yang PC, Liang DH, McConnell MV, Rosenthal DN. A visual approach for the accurate determination of echocardiographic left ventricular ejection fraction by medical students. J Am Soc Echocardiogr. 2003;16:824–31.PubMedCrossRefGoogle Scholar
  29. 29.
    Spencer KT, Lang RM, Kirkpatrick JN, Mor-Avi V. Assessment of global and regional left ventricular diastolic function in hypertensive heart disease using automated border detection techniques. Echocardiography. 2003;20:673–81.PubMedCrossRefGoogle Scholar
  30. 30.
    London MJ. Assessment of left ventricular global systolic function by transoesophageal echocardiography. Ann Card Anaesth. 2006;9:157–63.PubMedGoogle Scholar
  31. 31.
    Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.PubMedCrossRefGoogle Scholar
  32. 32.
    Nagueh SF, Appleton CP, Gillebert TC, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009;22:107–33.PubMedCrossRefGoogle Scholar
  33. 33.
    Fischer GW, Salgo IS, Adams DH. Real-time three-dimensional transesophageal echocardiography: the matrix revolution. J Cardiothorac Vasc Anesth. 2008;22:904–12.PubMedCrossRefGoogle Scholar
  34. 34.
    Mor-Avi V, Jenkins B, Kuhl H, et al. Real-time 3D echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of surces of error. JACC Cardiovasc Imaging. 2008;1:413–23.PubMedCrossRefGoogle Scholar
  35. 35.
    Pouleur AC, le Polain de Waroux JB, Pasquet A, et al. Assessment of left ventricular mass and volumes by three-dimensional echocardiography in patients with or without wall motion abnormalities: comparison against cine magnetic resonance imaging. Heart. 2008;94:1050–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Salgo IS. Three-dimensional echocardiographic technology. Cardiol Clin. 2007;25:231–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Vieira ML, Cury AF, Naccarato G, et al. Analysis of left ventricular regional dyssynchrony: comparison between real time 3D echocardiography and tissue Doppler imaging. Echocardiography. 2009;26:675–83.PubMedCrossRefGoogle Scholar
  38. 38.
    Liodakis E, Al Sharef O, Dawson D, Nihoyannopoulos P. The use of real time three dimensional echocardiography for assessing mechanical synchronicity. Heart. 2009;95(22):1865–71.PubMedCrossRefGoogle Scholar
  39. 39.
    Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29:277–314.PubMedCrossRefGoogle Scholar
  40. 40.
    Matyal R, Hess PE, Subramaniam B, et al. Perioperative diastolic dysfunction during vascular surgery and its association with postoperative outcome. J Vasc Surg. 2009;50:70–6.PubMedCrossRefGoogle Scholar
  41. 41.
    Swaminathan M, Nicoara A, Phillips-Bute BG, et al. Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery. Ann Thorac Surg. 2011;91:1844–50.PubMedCrossRefGoogle Scholar
  42. 42.
    Vizza CD, Lynch JP, Ochoa LL, Richardson G, Trulock EP. Right and left ventricular dysfunction in patients with severe pulmonary disease. Chest. 1998;113:576–83.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685–713; quiz 786-688.PubMedCrossRefGoogle Scholar
  44. 44.
    Pedoto A, Amar D. Right heart function in thoracic surgery: role of echocardiography. Curr Opin Anaesthesiol. 2009;22:44–9.CrossRefGoogle Scholar
  45. 45.
    Haddad F, Doyle R, Murphy DJ, Hunt SA. Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation. 2008;117:1717–31.CrossRefGoogle Scholar
  46. 46.
    Vieillard-Baron A. Assessment of right ventricular function. Curr Opin Crit Care. 2009;15:254–60.PubMedCrossRefGoogle Scholar
  47. 47.
    Davlouros PA, Niwa K, Webb G, Gatzoulis MA. The right ventricle in congenital heart disease. Heart. 2006;92(Suppl 1):i27–38.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: I. anatomy, physiology, and assessment. Anesth Analg. 2009;108:407–21.PubMedCrossRefGoogle Scholar
  49. 49.
    Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117:1436–48.PubMedCrossRefGoogle Scholar
  50. 50.
    Anavekar NS, Gerson D, Skali H, Kwong RY, Yucel EK, Solomon SD. Two-dimensional assessment of right ventricular function: an echocardiographic-MRI correlative study. Echocardiography. 2007;24:452–6.PubMedCrossRefGoogle Scholar
  51. 51.
    Silverton N, Meineri M. Speckle tracking strain of the right ventricle: an emerging tool for intraoperative echocardiography. Anesth Analg. 2017;125:1475.PubMedCrossRefGoogle Scholar
  52. 52.
    Duncan AE, Sarwar S, Kateby Kashy B, et al. Early left and right ventricular response to aortic valve replacement. Anesth Analg. 2015;Google Scholar
  53. 53.
    Meluzin J, Spinarova L, Hude P, et al. Prognostic importance of various echocardiographic right ventricular functional parameters in patients with symptomatic heart failure. J Am Soc Echocardiogr. 2005;18:435–44.PubMedCrossRefGoogle Scholar
  54. 54.
    Markin NW, Chamsi-Pasha M, Luo J, et al. Transesophageal speckle-tracking echocardiography improves right ventricular systolic function assessment in the perioperative setting. J Am Soc Echocardiogr. 2017;30:180–8.PubMedCrossRefGoogle Scholar
  55. 55.
    Fukuda S, Gillinov AM, McCarthy PM, et al. Determinants of recurrent or residual functional tricuspid regurgitation after tricuspid annuloplasty. Circulation. 2006;114:I582–7.PubMedGoogle Scholar
  56. 56.
    Rogers JH, Bolling SF. The tricuspid valve: current perspective and evolving management of tricuspid regurgitation. Circulation. 2009;119:2718–25.PubMedCrossRefGoogle Scholar
  57. 57.
    Fusini L, Tamborini G, Gripari P, et al. Feasibility of intraoperative three-dimensional transesophageal echocardiography in the evaluation of right ventricular volumes and function in patients undergoing cardiac surgery. J Am Soc Echocardiogr. 2011;24:868–77.PubMedCrossRefGoogle Scholar
  58. 58.
    Niemann PS, Pinho L, Balbach T, et al. Anatomically oriented right ventricular volume measurements with dynamic three-dimensional echocardiography validated by 3-Tesla magnetic resonance imaging. J Am Coll Cardiol. 2007;50:1668–76.PubMedCrossRefGoogle Scholar
  59. 59.
    Gopal AS, Chukwu EO, Iwuchukwu CJ, et al. Normal values of right ventricular size and function by real-time 3-dimensional echocardiography: comparison with cardiac magnetic resonance imaging. J Am Soc Echocardiogr. 2007;20:445–55.PubMedCrossRefGoogle Scholar
  60. 60.
    Kjaergaard J, Petersen CL, Kjaer A, Schaadt BK, Oh JK, Hassager C. Evaluation of right ventricular volume and function by 2D and 3D echocardiography compared to MRI. Eur J Echocardiogr. 2006;7:430–8.PubMedCrossRefGoogle Scholar
  61. 61.
    Lu X, Nadvoretskiy V, Bu L, et al. Accuracy and reproducibility of real-time three-dimensional echocardiography for assessment of right ventricular volumes and ejection fraction in children. J Am Soc Echocardiogr. 2008;21:84–9.PubMedCrossRefGoogle Scholar
  62. 62.
    Hagen PT, Scholz DG, Edwards WD. Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc. 1984;59:17–20.PubMedCrossRefGoogle Scholar
  63. 63.
    Schneider B, Zienkiewicz T, Jansen V, Hofmann T, Noltenius H, Meinertz T. Diagnosis of patent foramen ovale by transesophageal echocardiography and correlation with autopsy findings. Am J Cardiol. 1996;77:1202–9.PubMedCrossRefGoogle Scholar
  64. 64.
    Konstadt SN, Louie EK, Black S, Rao TL, Scanlon P. Intraoperative detection of patent foramen ovale by transesophageal echocardiography. Anesthesiology. 1991;74:212–6.PubMedCrossRefGoogle Scholar
  65. 65.
    Di Tullio M, Sacco RL, Venketasubramanian N, Sherman D, Mohr JP, Homma S. Comparison of diagnostic techniques for the detection of a patent foramen ovale in stroke patients. Stroke. 1993;24:1020–4.PubMedCrossRefGoogle Scholar
  66. 66.
    Woods TD, Patel A. A critical review of patent foramen ovale detection using saline contrast echocardiography: when bubbles lie. J Am Soc Echocardiogr. 2006;19:215–22.PubMedCrossRefGoogle Scholar
  67. 67.
    Thaler DE, Saver JL. Cryptogenic stroke and patent foramen ovale. Curr Opin Cardiol. 2008;23:537–44.PubMedCrossRefGoogle Scholar
  68. 68.
    Smeenk FW, Postmus PE. Interatrial right-to-left shunting developing after pulmonary resection in the absence of elevated right-sided heart pressures. Review of the literature. Chest. 1993;103:528–31.PubMedCrossRefGoogle Scholar
  69. 69.
    Carroll JD, Dodge S, Groves BM. Percutaneous patent foramen ovale closure. Cardiol Clin. 2005;23:13–33.PubMedCrossRefGoogle Scholar
  70. 70.
    Krasuski RA, Hart SA, Allen D, et al. Prevalence and repair of intraoperatively diagnosed patent foramen ovale and association with perioperative outcomes and long-term survival. JAMA. 2009;302:290–7.PubMedCrossRefGoogle Scholar
  71. 71.
    Cypel M, Yeung JC, Hirayama S, et al. Technique for prolonged normothermic ex vivo lung perfusion. J Heart Lung Transplant. 2008;27:1319–25.PubMedCrossRefGoogle Scholar
  72. 72.
    Cypel M, Sato M, Yildirim E, et al. Initial experience with lung donation after cardiocirculatory death in Canada. J Heart Lung Transplant. 2009;28:753–8.PubMedCrossRefGoogle Scholar
  73. 73.
    Gorcsan J 3rd, Edwards TD, Ziady GM, Katz WE, Griffith BP. Transesophageal echocardiography to evaluate patients with severe pulmonary hypertension for lung transplantation. Ann Thorac Surg. 1995;59:717–22.PubMedCrossRefGoogle Scholar
  74. 74.
    Izbicki G, Ben-Dor I, Shitrit D, et al. The prevalence of coronary artery disease in end-stage pulmonary disease: is pulmonary fibrosis a risk factor? Respir Med. 2009;103:1346–9.PubMedCrossRefGoogle Scholar
  75. 75.
    Jackson A, Cropper J, Pye R, Junius F, Malouf M, Glanville A. Use of extracorporeal membrane oxygenation as a bridge to primary lung transplant: 3 consecutive, successful cases and a review of the literature. J Heart Lung Transplant. 2008;27:348–52.PubMedCrossRefGoogle Scholar
  76. 76.
    Strueber M. Extracorporeal support as a bridge to lung transplantation. Curr Opin Crit Care. 2010;16(1):69–73.PubMedCrossRefGoogle Scholar
  77. 77.
    Cahalan MK, Stewart W, Pearlman A, et al. American Society of Echocardiography and Society of Cardiovascular Anesthesiologists task force guidelines for training in perioperative echocardiography. J Am Soc Echocardiogr. 2002;15:647–52.PubMedCrossRefGoogle Scholar
  78. 78.
    Practice guidelines for perioperative transesophageal echocardiography. A report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Anesthesiology. 1996;84:986–1006.Google Scholar
  79. 79.
    Ebert EC. Esophageal disease in scleroderma. J Clin Gastroenterol. 2006;40:769–75.PubMedCrossRefGoogle Scholar
  80. 80.
    Della Rocca G, Brondani A, Costa MG. Intraoperative hemodynamic monitoring during organ transplantation: what is new? Curr Opin Organ Transplant. 2009;14:291–6.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Marasco SF, Lukas G, McDonald M, McMillan J, Ihle B. Review of ECMO (extra corporeal membrane oxygenation) support in critically ill adult patients. Heart Lung Circ. 2008;17(Suppl 4):S41–7.PubMedCrossRefGoogle Scholar
  82. 82.
    Doufle G, Roscoe A, Billia F, Fan E. Echocardiography for adult patients supported with extracorporeal membrane oxygenation. Crit Care. 2015;19:326.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Gammie JS, Cheul Lee J, Pham SM, et al. Cardiopulmonary bypass is associated with early allograft dysfunction but not death after double-lung transplantation. J Thorac Cardiovasc Surg. 1998;115:990–7.PubMedCrossRefGoogle Scholar
  84. 84.
    Paradela M, Gonzalez D, Parente I, et al. Surgical risk factors associated with lung transplantation. Transplant Proc. 2009;41:2218–20.PubMedCrossRefGoogle Scholar
  85. 85.
    Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: II. Pathophysiology, clinical importance, and management. Anesth Analg. 2009;108:422–33.PubMedCrossRefGoogle Scholar
  86. 86.
    Subramaniam K, Yared JP. Management of pulmonary hypertension in the operating room. Semin Cardiothorac Vasc Anesth. 2007;11:119–36.PubMedCrossRefGoogle Scholar
  87. 87.
    Murtha W, Guenther C. Dynamic left ventricular outflow tract obstruction complicating bilateral lung transplantation. Anesth Analg. 2002;94:558–9; table of contents.PubMedCrossRefGoogle Scholar
  88. 88.
    Granton J, Moric J. Pulmonary vasodilators--treating the right ventricle. Anesthesiol Clin. 2008;26:337–53. vii.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Katz WE, Gasior TA, Quinlan JJ, et al. Immediate effects of lung transplantation on right ventricular morphology and function in patients with variable degrees of pulmonary hypertension. J Am Coll Cardiol. 1996;27:384–91.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Hausmann D, Daniel WG, Mugge A, et al. Imaging of pulmonary artery and vein anastomoses by transesophageal echocardiography after lung transplantation. Circulation. 1992;86:II251–8.PubMedGoogle Scholar
  91. 91.
    Reeves ST, Glas KE, Eltzschig H, et al. Guidelines for performing a comprehensive epicardial echocardiography examination: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2007;20:427–37.PubMedCrossRefGoogle Scholar
  92. 92.
    Gonzalez-Fernandez C, Gonzalez-Castro A, Rodriguez-Borregan JC, et al. Pulmonary venous obstruction after lung transplantation. Diagnostic advantages of transesophageal echocardiography. Clin Transplant. 2009;23(6):975–80.PubMedCrossRefGoogle Scholar
  93. 93.
    Michel-Cherqui M, Brusset A, Liu N, et al. Intraoperative transesophageal echocardiographic assessment of vascular anastomoses in lung transplantation. A report on 18 cases. Chest. 1997;111:1229–35.PubMedCrossRefGoogle Scholar
  94. 94.
    Schulman LL, Anandarangam T, Leibowitz DW, et al. Four-year prospective study of pulmonary venous thrombosis after lung transplantation. J Am Soc Echocardiogr. 2001;14:806–12.PubMedCrossRefGoogle Scholar
  95. 95.
    Felten ML, Michel-Cherqui M, Sage E, Fischler M. Transesophageal and contact ultrasound echographic assessments of pulmonary vessels in bilateral lung transplantation. Ann Thorac Surg. 2012;93:1094–100.PubMedCrossRefGoogle Scholar
  96. 96.
    Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119:e391–479.PubMedGoogle Scholar
  97. 97.
    Jacobsohn E, Avidan MS, Hantler CB, Rosemeier F, De Wet CJ. Case report: inferior vena-cava right atrial anastomotic stenosis after bicaval orthotopic heart transplantation. Can J Anaesth. 2006;53:1039–43.PubMedCrossRefGoogle Scholar
  98. 98.
    Rosenberger P, Shernan SK, Mihaljevic T, Eltzschig HK. Transesophageal echocardiography for detecting extrapulmonary thrombi during pulmonary embolectomy. Ann Thorac Surg. 2004;78:862–6; discussion 866.PubMedCrossRefGoogle Scholar
  99. 99.
    Comess KA, DeRook FA, Russell ML, Tognazzi-Evans TA, Beach KW. The incidence of pulmonary embolism in unexplained sudden cardiac arrest with pulseless electrical activity. Am J Med. 2000;109:351–6.PubMedCrossRefGoogle Scholar
  100. 100.
    Aklog L, Williams CS, Byrne JG, Goldhaber SZ. Acute pulmonary embolectomy: a contemporary approach. Circulation. 2002;105:1416–9.PubMedCrossRefGoogle Scholar
  101. 101.
    Thistlethwaite PA, Kaneko K, Madani MM, Jamieson SW. Technique and outcomes of pulmonary endarterectomy surgery. Ann Thorac Cardiovasc Surg. 2008;14:274–82.PubMedGoogle Scholar
  102. 102.
    Lengyel M. The role of transesophageal echocardiography in the management of patients with acute and chronic pulmonary thromboembolism. Echocardiography. 1995;12:359–66.PubMedCrossRefGoogle Scholar
  103. 103.
    Chartier L, Bera J, Delomez M, et al. Free-floating thrombi in the right heart: diagnosis, management, and prognostic indexes in 38 consecutive patients. Circulation. 1999;99:2779–83.PubMedCrossRefGoogle Scholar
  104. 104.
    Ribeiro A, Lindmarker P, Juhlin-Dannfelt A, Johnsson H, Jorfeldt L. Echocardiography Doppler in pulmonary embolism: right ventricular dysfunction as a predictor of mortality rate. Am Heart J. 1997;134:479–87.PubMedCrossRefGoogle Scholar
  105. 105.
    Konstantinides S, Geibel A, Kasper W, Olschewski M, Blumel L, Just H. Patent foramen ovale is an important predictor of adverse outcome in patients with major pulmonary embolism. Circulation. 1998;97:1946–51.PubMedCrossRefGoogle Scholar
  106. 106.
    Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003;16:777–802.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Tousignant C, Van Orman JR. Pulmonary artery acceleration time in cardiac surgical patients. J Cardiothorac Vasc Anesth. 2015;29:1517–23.PubMedCrossRefGoogle Scholar
  108. 108.
    Hardziyenka M, Reesink HJ, Bouma BJ, et al. A novel echocardiographic predictor of in-hospital mortality and mid-term haemodynamic improvement after pulmonary endarterectomy for chronic thrombo-embolic pulmonary hypertension. Eur Heart J. 2007;28:842–9.PubMedCrossRefGoogle Scholar
  109. 109.
    D'Armini AM, Zanotti G, Ghio S, et al. Reverse right ventricular remodeling after pulmonary endarterectomy. J Thorac Cardiovasc Surg. 2007;133:162–8.PubMedCrossRefGoogle Scholar
  110. 110.
    Brooker RF, Zvara DA, Roitstein A. Mediastinal mass diagnosed with intraoperative transesophageal echocardiography. J Cardiothorac Vasc Anesth. 2007;21:257–8.PubMedCrossRefGoogle Scholar
  111. 111.
    Lin CM, Hsu JC. Anterior mediastinal tumour identified by intraoperative transesophageal echocardiography. Can J Anaesth. 2001;48:78–80.CrossRefGoogle Scholar
  112. 112.
    Tsutsui JM, Hueb WA, Nascimento SA, Borges Leal SM, de Andrade JL, Mathias W Jr. Detection of retained surgical sponge by transthoracic and transesophageal echocardiography. J Am Soc Echocardiogr. 2003;16:1191–3.PubMedCrossRefGoogle Scholar
  113. 113.
    Shah A, Tunick PA, Greaney E, Pfeffer RD, Kronzon I. Diagnosis of esophageal carcinoma because of findings on transesophageal echocardiography. J Am Soc Echocardiogr. 2001;14:1134–6.PubMedCrossRefGoogle Scholar
  114. 114.
    Redford DT, Kim AS, Barber BJ, Copeland JG. Transesophageal echocardiography for the intraoperative evaluation of a large anterior mediastinal mass. Anesth Analg. 2006;103:578–9.PubMedCrossRefGoogle Scholar
  115. 115.
    DeBoer DA, Margolis ML, Livornese D, Bell KA, Livolsi VA, Bavaria JE. Pulmonary venous aneurysm presenting as a middle mediastinal mass. Ann Thorac Surg. 1996;61:1261–2.PubMedCrossRefGoogle Scholar
  116. 116.
    Schroder C, Schonhofer B, Vogel B. Transesophageal echographic determination of aortic invasion by lung cancer. Chest. 2005;127:438–42.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of AnesthesiaToronto General Hospital, University of TorontoTorontoCanada

Personalised recommendations