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Intraoperative Transesophageal Echocardiography for Thoracic Surgery

  • Massimiliano Meineri
Chapter

Abstract

Despite its intuitive advantages, the use of TEE in noncardiac surgery has been limited by the availability of trained anesthesiologists, the cost of the equipment and, ultimately, by the lack of updated guidelines. In fact, very few studies have looked at the impact of intraoperative TEE in noncardiac surgery on patients’ outcomes. TEE is a considered a safe technique. However, despite its relative noninvasiveness, it carries potentially drastic complications and needs to be supported by congruent indications. Basic hemodynamic monitoring can be easily achieved with TEE. Qualitative and quantitative assessments of right and left ventricular function are feasible and can be integrated as a complete standard in intraoperative hemodynamic monitoring. TEE for lung transplant is considered a category II indication by current guidelines. TEE provides ideal intraoperative hemodynamic monitoring, and it allows the assessment of all vascular anastomoses immediately after the reperfusion of the graft. TEE has a promising role in the diagnosis and follow-up of both acute and chronic pulmonary embolisms. TEE can easily detect and monitor the effects of acute and chronic pressure overload on the right ventricle and can rule out dangerous intracardiac shunts. These characteristics make it a powerful tool for intraoperative monitoring during ­pulmonary embolectomy and endarterectomy surgeries. The ability to image cardiac structures with a high spatial resolution makes TEE suitable for assessing the effect of mediastinal masses on cardiac chambers. TEE may also provide useful information to guide surgical resection.

Keywords

Right Ventricular Inferior Vena Cava Right Ventricular Function Right Ventricular Dysfunction Noncardiac Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

TEE

Transesophageal echocardiography

3D TEE

Three-dimensional trasesophageal echocardiography

TTE

Transthoracic echocardiography

Anatomy

LV

Left ventricle

RV

Right ventricle

LA

Left atrium

RA

Right atrium

LVOT

Left ventricular outflow tract

RVOT

Right ventricular outflow tract

PFO

Patent foramen ovale

TV

Tricuspid valve

PV

Pulmonic valve

IAS

Interatrial septum

IVS

Interventricular septum

IVC

Inferior vena cava

SVC

Superior vena cava

PA

Pulmonary artery

RPA

Right pulmonary artery

LPA

Left pulmonary artery

PV

Pulmonary veins

LUPV

Left upper pulmonary vein

LLPV

Left lower pulmonary vein

RUPV

Right upper pulmonary vein

RLPV

Right lower pulmonary vein

TEE views

TG SAX

Transgastric short axis view

ME 4C

Mid-esophageal four-chamber view

ME 2C

Mid-esophageal two-chamber view

ME RV in–out

Mid-esophageal right ventricle inflow–outflow view

ME BiC

Mid-esophageal bicaval view

ME Asc Ao SAX

Mid-esophageal ascending aorta short axis view

UE Ao Arch SAX

Upper-esophageal aortic arch short axis view

Measures

LVEDD

Left ventricular end-diastolic diameter

LVESD

Left ventricular end-systolic diameter

LVEDA

Left ventricular end-diastolic diameter

LVESA

Left ventricular end-systolic area

LVEDV

Left ventricular end-diastolic volume

LVESV

Left ventricular end-systolic volume

RVEDA

Right ventricular end-diastolic area

FS

Fractional shortening

FAC

Fractional area change

LVEF

Left ventricular ejection fraction

SV

Stroke volume

TAPSE

Tricuspid valve annular plane systolic excursion

TR

Tricuspid regurgitation

RVSP

Right ventricular systolic pressure

References

  1. 1.
    Mahmood F, Christie A, Matyal R. Transesophageal echocardiography and noncardiac surgery. Semin Cardiothorac Vasc Anesth. 2008;12(4):265–89.PubMedGoogle Scholar
  2. 2.
    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(4):986–1006.Google Scholar
  3. 3.
    Brandt RR, Oh JK, Abel MD, Click RL, Orszulak TA, Seward JB. Role of emergency intraoperative transesophageal echocardiography. J Am Soc Echocardiogr. 1998;11(10):972–7.PubMedGoogle Scholar
  4. 4.
    Canty DJ, Royse CF. Audit of anaesthetist-performed echocardiography on perioperative management decisions for non-cardiac surgery. Br J Anaesth. 2009;103(3):352–8.PubMedGoogle Scholar
  5. 5.
    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(3):287–93.PubMedGoogle Scholar
  6. 6.
    Hofer CK, Zollinger A, Rak M, et al. Therapeutic impact of intra-operative transoesophageal echocardiography during noncardiac surgery. Anaesthesia. 2004;59(1):3–9.PubMedGoogle Scholar
  7. 7.
    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(8):767–73.PubMedGoogle Scholar
  8. 8.
    Suriani RJ, Neustein S, Shore-Lesserson L, Konstadt S. Intraoperative transesophageal echocardiography during noncardiac surgery. J Cardiothorac Vasc Anesth. 1998;12(3):274–80.PubMedGoogle Scholar
  9. 9.
    Schulmeyer MC, Santelices E, Vega R, Schmied S. Impact of intraoperative transesophageal echocardiography during noncardiac surgery. J Cardiothorac Vasc Anesth. 2006;20(6):768–71.PubMedGoogle Scholar
  10. 10.
    Memtsoudis SG, Rosenberger P, Loffler M, et al. The usefulness of transesophageal echocardiography during intraoperative cardiac arrest in noncardiac surgery. Anesth Analg. 2006;102(6): 1653–7.PubMedGoogle Scholar
  11. 11.
    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(3):780–3.PubMedGoogle Scholar
  12. 12.
    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(6):1384–8.PubMedGoogle Scholar
  13. 13.
    Serra E, Feltracco P, Barbieri S, Forti A, Ori C. Transesophageal echocardiography during lung transplantation. Transplant Proc. 2007;39(6):1981–2.PubMedGoogle Scholar
  14. 14.
  15. 15.
    Cote G, Denault A. Transesophageal echocardiography-related complications. Can J Anaesth. 2008;55(9):622–47.PubMedGoogle Scholar
  16. 16.
    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(5):e5–7. 579.PubMedGoogle Scholar
  17. 17.
    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(3):379–84.PubMedGoogle Scholar
  18. 18.
    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(5):1126–30.PubMedGoogle Scholar
  19. 19.
    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(1):62–5.PubMedGoogle Scholar
  20. 20.
    Shanewise JS, Cheung AT, Aronson S, et al. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography. J Am Soc Echocardiogr. 1999;12(10):884–900.PubMedGoogle Scholar
  21. 21.
    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(4):945–54.PubMedGoogle Scholar
  22. 22.
    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(2):210–6.PubMedGoogle Scholar
  23. 23.
    Royse CF. Ultrasound-guided haemodynamic state assessment. Best Pract Res Clin Anaesthesiol. 2009;23(3):273–83.PubMedGoogle Scholar
  24. 24.
    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(3):721–8.PubMedGoogle Scholar
  25. 25.
    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(2):79–83.PubMedGoogle Scholar
  26. 26.
    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(9):849–55.PubMedGoogle Scholar
  27. 27.
    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(4):272–8.PubMedGoogle Scholar
  28. 28.
    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(9):759–65.PubMedGoogle Scholar
  29. 29.
    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(8):824–31.PubMedGoogle Scholar
  30. 30.
    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(7):673–81.PubMedGoogle Scholar
  31. 31.
    London MJ. Assessment of left ventricular global systolic function by transoesophageal echocardiography. Ann Card Anaesth. 2006;9(2):157–63.PubMedGoogle Scholar
  32. 32.
    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(12):1440–63.PubMedGoogle Scholar
  33. 33.
    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(2):107–33.PubMedGoogle Scholar
  34. 34.
    Fischer GW, Salgo IS, Adams DH. Real-time three-dimensional transesophageal echocardiography: the matrix revolution. J Cardiothorac Vasc Anesth. 2008;22(6):904–12.PubMedGoogle Scholar
  35. 35.
    Mor-Avi V, Jenkins B, Kuhl H, et al. Real-time 3D echocardiographic quantification of left ventricular volumes: multicenter srudy for validation with magnetic resonance imaging and investigation of sources of error. JACC Cardiovasc Imaging. 2008;1:413–23.PubMedGoogle Scholar
  36. 36.
    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(8):1050–7.PubMedGoogle Scholar
  37. 37.
    Salgo IS. Three-dimensional echocardiographic technology. Cardiol Clin. 2007;25(2):231–9.PubMedGoogle Scholar
  38. 38.
    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(6):675–83.PubMedGoogle Scholar
  39. 39.
    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.PubMedGoogle 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(1):70–6.PubMedGoogle Scholar
  41. 41.
    Vizza CD, Lynch JP, Ochoa LL, Richardson G, Trulock EP. Right and left ventricular dysfunction in patients with severe pulmonary disease. Chest. 1998;113(3):576–83.PubMedGoogle Scholar
  42. 42.
    Pedoto A, Amar D. Right heart function in thoracic surgery: role of echocardiography. Curr Opin Anaesthesiol. 2009;22(1): 44–9.PubMedGoogle Scholar
  43. 43.
    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(13):1717–31.PubMedGoogle Scholar
  44. 44.
    Vieillard-Baron A. Assessment of right ventricular function. Curr Opin Crit Care. 2009;15(3):254–60.PubMedGoogle Scholar
  45. 45.
    Davlouros PA, Niwa K, Webb G, Gatzoulis MA. The right ventricle in congenital heart disease. Heart. 2006;92 Suppl 1:i27–38.PubMedGoogle Scholar
  46. 46.
    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(2):407–21.PubMedGoogle Scholar
  47. 47.
    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(11):1436–48.PubMedGoogle Scholar
  48. 48.
    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(5):452–6.PubMedGoogle Scholar
  49. 49.
    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(5):435–44.PubMedGoogle Scholar
  50. 50.
    Fukuda S, Gillinov AM, McCarthy PM, et al. Determinants of recurrent or residual functional tricuspid regurgitation after ­tricuspid annuloplasty. Circulation. 2006;114(1 Suppl):I582–7.PubMedGoogle Scholar
  51. 51.
    Rogers JH, Bolling SF. The tricuspid valve: current perspective and evolving management of tricuspid regurgitation. Circulation. 2009;119(20):2718–25.PubMedGoogle Scholar
  52. 52.
    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(17):1668–76.PubMedGoogle Scholar
  53. 53.
    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(5):445–55.PubMedGoogle Scholar
  54. 54.
    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(6):430–8.PubMedGoogle Scholar
  55. 55.
    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(1):84–9.PubMedGoogle Scholar
  56. 56.
    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(1):17–20.PubMedGoogle Scholar
  57. 57.
    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(14):1202–9.PubMedGoogle Scholar
  58. 58.
    Konstadt SN, Louie EK, Black S, Rao TL, Scanlon P. Intraoperative detection of patent foramen ovale by transesophageal echocardiography. Anesthesiology. 1991;74(2):212–6.PubMedGoogle Scholar
  59. 59.
    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(7):1020–4.PubMedGoogle Scholar
  60. 60.
    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(2):215–22.PubMedGoogle Scholar
  61. 61.
    Thaler DE, Saver JL. Cryptogenic stroke and patent foramen ovale. Curr Opin Cardiol. 2008;23(6):537–44.PubMedGoogle Scholar
  62. 62.
    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(2):528–31.PubMedGoogle Scholar
  63. 63.
    Carroll JD, Dodge S, Groves BM. Percutaneous patent foramen ovale closure. Cardiol Clin. 2005;23(1):13–33.PubMedGoogle Scholar
  64. 64.
    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(3):290–7.PubMedGoogle Scholar
  65. 65.
    Cypel M, Yeung JC, Hirayama S, et al. Technique for prolonged normothermic ex vivo lung perfusion. J Heart Lung Transplant. 2008;27(12):1319–25.PubMedGoogle Scholar
  66. 66.
    Cypel M, Sato M, Yildirim E, et al. Initial experience with lung donation after cardiocirculatory death in Canada. J Heart Lung Transplant. 2009;28(8):753–8.PubMedGoogle Scholar
  67. 67.
    Gorcsan III J, 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(3):717–22.PubMedGoogle Scholar
  68. 68.
    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(9):1346–9.PubMedGoogle Scholar
  69. 69.
    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(3): 348–52.PubMedGoogle Scholar
  70. 70.
    Strueber M. Extracorporeal support as a bridge to lung transplantation. Curr Opin Crit Care. 2009;15(1):52–8.Google Scholar
  71. 71.
    Ebert EC. Esophageal disease in scleroderma. J Clin Gastroenterol. 2006;40(9):769–75.PubMedGoogle Scholar
  72. 72.
    Della Rocca G, Brondani A, Costa MG. Intraoperative hemodynamic monitoring during organ transplantation: what is new? Curr Opin Organ Transplant. 2009;14(3):291–6.PubMedGoogle Scholar
  73. 73.
    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.PubMedGoogle Scholar
  74. 74.
    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(5):990–7.PubMedGoogle Scholar
  75. 75.
    Paradela M, Gonzalez D, Parente I, et al. Surgical risk factors associated with lung transplantation. Transplant Proc. 2009;41(6):2218–20.PubMedGoogle Scholar
  76. 76.
    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(2):422–33.PubMedGoogle Scholar
  77. 77.
    Subramaniam K, Yared JP. Management of pulmonary hypertension in the operating room. Semin Cardiothorac Vasc Anesth. 2007;11(2):119–36.PubMedGoogle Scholar
  78. 78.
    Murtha W, Guenther C. Dynamic left ventricular outflow tract obstruction complicating bilateral lung transplantation. Anesth Analg. 2002;94(3):558–9. table of contents.PubMedGoogle Scholar
  79. 79.
    Granton J, Moric J. Pulmonary vasodilators – treating the right ventricle. Anesthesiol Clin. 2008;26(2):337–53. vii.PubMedGoogle Scholar
  80. 80.
    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(2):384–91.PubMedGoogle Scholar
  81. 81.
    Hausmann D, Daniel WG, Mugge A, et al. Imaging of pulmonary artery and vein anastomoses by transesophageal echocardiography after lung transplantation. Circulation. 1992;86(5 Suppl):II251–8.PubMedGoogle Scholar
  82. 82.
    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(4):427–37.PubMedGoogle Scholar
  83. 83.
    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.PubMedGoogle Scholar
  84. 84.
    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(5):1229–35.PubMedGoogle Scholar
  85. 85.
    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(8):806–12.PubMedGoogle Scholar
  86. 86.
    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(14):e391–479.PubMedGoogle Scholar
  87. 87.
    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(10):1039–43.PubMedGoogle Scholar
  88. 88.
    Rosenberger P, Shernan SK, Mihaljevic T, Eltzschig HK. Transesophageal echocardiography for detecting extrapulmonary thrombi during pulmonary embolectomy. Ann Thorac Surg. 2004;78(3):862–6. Discussion 866.PubMedGoogle Scholar
  89. 89.
    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(5):351–6.PubMedGoogle Scholar
  90. 90.
    Aklog L, Williams CS, Byrne JG, Goldhaber SZ. Acute pulmonary embolectomy: a contemporary approach. Circulation. 2002;105(12):1416–9.PubMedGoogle Scholar
  91. 91.
    Thistlethwaite PA, Kaneko K, Madani MM, Jamieson SW. Technique and outcomes of pulmonary endarterectomy surgery. Ann Thorac Cardiovasc Surg. 2008;14(5):274–82.PubMedGoogle Scholar
  92. 92.
    Lengyel M. The role of transesophageal echocardiography in the management of patients with acute and chronic ­pulmonary thromboembolism. Echocardiography. 1995;12(4):359–66.PubMedGoogle Scholar
  93. 93.
    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(21): 2779–83.PubMedGoogle Scholar
  94. 94.
    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(3):479–87.PubMedGoogle Scholar
  95. 95.
    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(19):1946–51.PubMedGoogle Scholar
  96. 96.
    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(7):777–802.PubMedGoogle Scholar
  97. 97.
    D’Armini AM, Zanotti G, Ghio S, et al. Reverse right ventricular remodeling after pulmonary endarterectomy. J Thorac Cardiovasc Surg. 2007;133(1):162–8.PubMedGoogle Scholar
  98. 98.
    Brooker RF, Zvara DA, Roitstein A. Mediastinal mass diagnosed with intraoperative transesophageal echocardiography. J Cardiothorac Vasc Anesth. 2007;21(2):257–8.PubMedGoogle Scholar
  99. 99.
    Lin CM, Hsu JC. Anterior mediastinal tumour identified by intraoperative transesophageal echocardiography. Can J Anaesth. 2001;48(1):78–80.PubMedGoogle Scholar
  100. 100.
    Tsutsui JM, Hueb WA, Nascimento SA, Borges Leal SM, de Andrade JL, Mathias Jr W. Detection of retained surgical sponge by transthoracic and transesophageal echocardiography. J Am Soc Echocardiogr. 2003;16(11):1191–3.PubMedGoogle Scholar
  101. 101.
    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(11): 1134–6.PubMedGoogle Scholar
  102. 102.
    Redford DT, Kim AS, Barber BJ, Copeland JG. Transesophageal echocardiography for the intraoperative evaluation of a large anterior mediastinal mass. Anesth Analg. 2006;103(3):578–9.PubMedGoogle Scholar
  103. 103.
    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(4):1261–2.PubMedGoogle Scholar
  104. 104.
    Schroder C, Schonhofer B, Vogel B. Transesophageal echographic determination of aortic invasion by lung cancer. Chest. 2005;127(2):438–42.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Massimiliano Meineri
    • 1
  1. 1.Department of AnesthesiaToronto General Hospital, University of TorontoTorontoCanada

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