Best Practice & Research Clinical Anaesthesiology
Volume 23, Issue 3 , Pages 263-271 , September 2009

The impact of routine Trans-oesophageal Echocardiography (TOE) in cardiac surgery

  • Georges Desjardins, MD (Associate Professor of Anesthesiology and Medicine (Cardiology), Director of Cardiac Anesthesiology and Perioperative Echocardiography)

      Affiliations

    • University of Utah School of Medicine, 30 North 1900 East Room 3C444, Salt Lake City, UT 84132, USA
    • University of Utah Hospitals and Clinics, 30 North 1900 East Room 3C444, Salt Lake City, UT 84132, USA
  • ,
  • Michael Cahalan, MD (Professor and Chair of Anesthesiology)

      Affiliations

    • University of Utah School of Medicine, 30 North 1900 East Room 3C444, Salt Lake City, UT 84132, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 801 581 6393; Fax: +1 801 581 4367.

References 

  1. Lowenstein E, Hallowell P, Levine FH, et al. Cardiovascular response to large doses of intravenous morphine in man. The New England Journal of Medicine. 1969;281:1389–1393
  2. Mary DA, Catchpole LA, Ionescu MI. Intraoperative echocardiographic studies of the mitral valve: assessment of commissurotomy and repair. Journal of Clinical Ultrasound. 1976;4:349–356
  3. Frazin L, Talano JV, Stephanides L, et al. Esophageal echocardiography. Circulation. 1976;54:102–108
  4. Schluter M, Langenstein BA, Polster J, et al. Transoesophageal cross-sectional echocardiography with a phased array transducer system. Technique and initial clinical results. British Heart Journal. 1982;48:67–72
  5. Qaddoura FE, Abel MD, Mecklenburg KL, et al. Role of intraoperative transesophageal echocardiography in patients having coronary artery bypass graft surgery. Annals of Thoracic Surgery. 2004;78:1586–1590
  6. Click RL, Abel MD, Schaff HV. Intraoperative transesophageal echocardiography: 5-year prospective review of impact on surgical management. Mayo Clinic Proceedings. 2000;75:241–247
  7. Mishra M, Chauhan R, Sharma KK, et al. Real-time intraoperative transesophageal echocardiography–how useful? Experience of 5,016 cases. Journal of Cardiothoracic and Vascular Anesthesia. 1998;12:625–632
  8. Moore AG, Eagle KA, Bruckman D, et al. Choice of computed tomography, transesophageal echocardiography, magnetic resonance imaging, and aortography in acute aortic dissection: International Registry of Acute Aortic Dissection (IRAD). American Journal of Cardiology. 2002;89:1235–1238
  9. Movsowitz HD, Levine RA, Hilgenberg AD, Isselbacher EM. Transesophageal echocardiographic description of the mechanisms of aortic regurgitation in acute type A aortic dissection: implications for aortic valve repair. Journal of the American College of Cardiology. 2000;36:884–890
  10. Bossone E, Evangelista A, Isselbacher E, et al. Prognostic role of transesophageal echocardiography in acute type A aortic dissection. American Heart Journal. 2007;153:1013–1020
  11. Katz ES, Tunick PA, Rusinek H, et al. Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: experience with intraoperative transesophageal echocardiography. Journal of the American College of Cardiology. 1992;20:70–77
  12. Gold JP, Torres KE, Maldarelli W, et al. Improving outcomes in coronary surgery: the impact of echo-directed aortic cannulation and perioperative haemodynamic management in 500 patients. Annals of Thoracic Surgery. 2004;78:1579–1585
  13. Hartman GS, Yao FS, Bruefach M, et al. Severity of aortic atheromatous disease diagnosed by transesophageal echocardiography predicts stroke and other outcomes associated with coronary artery surgery: a prospective study. Anesthesia and Analgesia. 1996;83:701–708
  14. Konstadt SN, Reich DL, Kahn R, Viggiani RF. Transesophageal echocardiography can be used to screen for ascending aortic atherosclerosis. Anesthesia and Analgesia. 1995;81:225–228
  15. Mishra M, Malhotra R, Karlekar A, et al. Propensity case-matched analysis of off-pump versus on-pump coronary artery bypass grafting in patients with atheromatous aorta. Annals of Thoracic Surgery. 2006;82:608–614
  16. Agricola E, Oppizzi M, Maisano F, et al. Detection of mechanisms of immediate failure by transesophageal echocardiography in quadrangular resection mitral valve repair technique for severe mitral regurgitation. American Journal of Cardiology. 2003;91:175–179
  17. Shin HJ, Lee YJ, Choo SJ, et al. Analysis of recurrent mitral regurgitation after mitral valve repair. Asian Cardiovascular and Thoracic Annals. 2005;13:261–266
  18. Brown ML, Abel MD, Click RL, et al. Systolic anterior motion after mitral valve repair: is surgical intervention necessary?. The Journal of Thoracic and Cardiovascular Surgery. 2007;133:136–143
  19. de Waroux JB, Pouleur AC, Goffinet C, et al. Functional anatomy of aortic regurgitation: accuracy, prediction of surgical repairability, and outcome implications of transesophageal echocardiography. Circulation. 2007;116:I264–I269
  20. Shapira Y, Vaturi M, Weisenberg DE, et al. Impact of intraoperative transesophageal echocardiography in patients undergoing valve replacement. Annals of Thoracic Surgery. 2004;78:579–583discussion 583–4
  21. Savage RM, Lytle BW, Aronson S, et al. Intraoperative echocardiography is indicated in high-risk coronary artery bypass grafting. Annals of Thoracic Surgery. 1997;64:368–373discussion 373–4
  22. Stevenson JG, Sorensen GK, Gartman DM, et al. Transesophageal echocardiography during repair of congenital cardiac defects: identification of residual problems necessitating reoperation. Journal of the American Society of Echocardiography. 1993;6:356–365
  23. Stevenson JG. Adherence to physician training guidelines for pediatric transesophageal echocardiography affects the outcome of patients undergoing repair of congenital cardiac defects. Journal of the American Society of Echocardiography. 1999;12:165–172
  24. Russell IA, Rouine-Rapp K, Stratmann G, Miller-Hance WC. Congenital heart disease in the adult: a review with internet-accessible transesophageal echocardiographic images. Anesthesia and Analgesia. 2006;102:694–723
  25. Cheung AT, Savino JS, Weiss SJ, et al. Echocardiographic and hemodynamic indexes of left ventricular preload in patients with normal and abnormal ventricular function. Anesthesiology. 1994;81:376–387
  26. Tousignant CP, Walsh F, Mazer CD. The use of transesophageal echocardiography for preload assessment in critically ill patients. Anesthesia and Analgesia. 2000;90:351–355
  27. Swenson JD, Bull D, Stringham J. Subjective assessment of left ventricular preload using transesophageal echocardiography: corresponding pulmonary artery occlusion pressures. Journal of Cardiothoracic and Vascular Anesthesia. 2001;15:580–583
  28. Kuecherer HF, Muhiudeen IA, Kusumoto FM, et al. Estimation of mean left atrial pressure from transesophageal pulsed Doppler echocardiography of pulmonary venous flow. Circulation. 1990;82:1127–1139
  29. Nomura M, Hillel Z, Shih H, et al. The association between Doppler transmitral flow variables measured by transesophageal echocardiography and pulmonary capillary wedge pressure. Anesthesia and Analgesia. 1997;84:491–496
  30. Darmon PL, Hillel Z, Mogtader A, et al. Cardiac output by transesophageal echocardiography using continuous-wave Doppler across the aortic valve. Anesthesiology. 1994;80:796–805
  31. Balik M, Pachl J, Hendl J, et al. Effect of the degree of tricuspid regurgitation on cardiac output measurements by thermodilution. Intensive Care Medicine. 2002;28:1117–1121
  32. Hoit BD. Left ventricular diastolic function. Critical Care Medicine. 2007;35:S340–S347
  33. Smith JS, Cahalan MK, Benefiel DJ, et al. Intraoperative detection of myocardial ischemia in high-risk patients: electrocardiography versus two-dimensional transesophageal echocardiography. Circulation. 1985;72:1015–1021
  34. van Daele ME, Sutherland GR, Mitchell MM, et al. Do changes in pulmonary capillary wedge pressure adequately reflect myocardial ischemia during anesthesia? A correlative preoperative hemodynamic, electrocardiographic, and transesophageal echocardiographic study. Circulation. 1990;81:865–871
  35. Rouine-Rapp K, Ionescu P, Balea M, et al. Detection of intraoperative segmental wall-motion abnormalities by transesophageal echocardiography: the incremental value of additional cross sections in the transverse and longitudinal planes. Anesthesia and Analgesia. 1996;83:1141–1148
  36. Cwajg JM, Cwajg E, Nagueh SF, et al. End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation: relation to rest-redistribution T1-201 tomography and dobutamine stress echocardiography. Journal of the American College of Cardiology. 2000;35:1152–1161
  37. Afridi I, Kleiman NS, Raizner AE, Zoghbi WA. Dobutamine echocardiography in myocardial hibernation. Optimal dose and accuracy in predicting recovery of ventricular function after coronary angioplasty. Circulation. 1995;91:663–670
  38. Seeberger MD, Cahalan MK, Rouine-Rapp K, et al. Acute hypovolemia may cause segmental wall motion abnormalities in the absence of myocardial ischemia. Anesthesia and Analgesia. 1997;85:1252–1257
  39. Reichert CL, Visser CA, Koolen JJ, et al. Transesophageal echocardiography in hypotensive patients after cardiac operations. Comparison with hemodynamic parameters. The Journal of Thoracic and Cardiovascular Surgery. 1992;104:321–326
  40. Cicek S, Demirilic U, Kuralay E, et al. Transesophageal echocardiography in cardiac surgical emergencies. Journal of Cardiac Surgery. 1995;10:236–244
  41. Cook CH, Praba AC, Beery PR, Martin LC. Transthoracic echocardiography is not cost-effective in critically ill surgical patients. The Journal of Trauma. 2002;52:280–284
  42. Eltzschig HK, Rosenberger P, Loffler M, et al. Impact of intraoperative transesophageal echocardiography on surgical decisions in 12,566 patients undergoing cardiac surgery. Annals of Thoracic Surgery. 2008;85:845–852

PII: S1521-6896(09)00024-X

doi: 10.1016/j.bpa.2009.02.007

Best Practice & Research Clinical Anaesthesiology
Volume 23, Issue 3 , Pages 263-271 , September 2009