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Society of Thoracic SurgeonsEchocardiography2020advanced

Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room

Published by American Society of Echocardiography in Collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons

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Summary

AI-generated

Intraoperative transesophageal echocardiography is a standard diagnostic and monitoring tool employed in the management of patients undergoing an entire spectrum of cardiac surgical procedures. Utilizing a protocol as a starting point enables standardization of image acquisition and better patient care.

transesophageal echocardiographyTEEASEcardiovascular anesthesiologythoracic surgeryperi‑operative echocardiographyadult cardiac surgeryguidelines

Key Takeaways

  • 1
    Intraoperative TEE is a standard diagnostic and monitoring tool for patients undergoing an entire spectrum of cardiac surgical procedures.
  • 2
    Utilizing a protocol as a starting point for imaging enables standardization of image acquisition and better patient care.
  • 3
    Clear communication of echocardiographic findings to the surgical team is a critical component of the intraoperative exam.
  • 4
    TEE is utilized to confirm preoperative diagnoses, detect new or unsuspected pathology, adjust anesthetic/surgical plans, and assess the results of interventions.

Scope & Objectives

Clinical Topic

Peri-Operative Echocardiography

Objectives

To outline a systematic approach describing how to apply the existing guidelines to questions on cardiac structure and function specific to the intraoperative environment in open, minimally invasive, or hybrid cardiac surgery procedures.

Target Patient Population

Adults undergoing open heart and thoracic aortic surgical procedures

Target Providers

EchocardiographersCardiovascular AnesthesiologistsCardiac Surgeons

Patient Criteria & Setting

Therapeutic Area

Cardiac Surgery

Guideline Scope

DiagnosisMonitoringSurgical Management

Inclusion Criteria

  • Adult patients
  • Patients undergoing open heart surgical procedures
  • Patients undergoing thoracic aortic surgical procedures

Exclusion Criteria

  • Patients undergoing structural heart disease transcatheter valve procedures

Care Settings

Operating Room

Special Populations

Organ transplant recipientsMechanical circulatory support patientsHypertrophic cardiomyopathy patientsPericardial disease patients

Safety & Contraindications

Monitoring Guidance

Combinations of echocardiographic modalities, including 2D, 3D, color flow, and spectral Doppler, are used to guide surgical interventions and monitor hemodynamic management throughout the surgical procedure.

Authors & Contributors

Alina NicoaraNikolaos SkubasNiv AdAlan FinleyRebecca T. HahnFeroze MahmoodSunil MankadCharles B. NymanFrancis PaganiThomas R. PorterKent RehfeldtMarc StoneBradley TaylorAnnette VegasKaren G. ZimmermanWilliam A. ZoghbiMadhav Swaminathan

Guideline Features

Flowcharts includedMultidisciplinary

Learning Context

Difficulty

advanced

Learning Paths

Perioperative EchocardiographyIntraoperative TEECardiac Surgery AssessmentValve Surgery ImagingMechanical Circulatory Support