Abstract
This chapter explains the role of perioperative transesophageal echocardiography in the care and treatment of an unstable surgical patient. Although it may encompass a broad range of anatomic imaging, noninvasive monitoring should focus on the cardiac causes of hemodynamic or ventilatory instability—including ventricular size and function, valvular anatomy and function, volume status, pericardial abnormalities, and complications from invasive procedures—as well as the clinical impact or the etiology of pulmonary dysfunction. Indeed, a basic perioperative transesophageal echocardiography examination is not designed to prepare practitioners for the use of the full diagnostic potential of transesophageal echocardiography, but sometimes it is needed to provide an advanced examination with detailed data on issues outside the scope of practice as defined within the related guidelines. We will, therefore, review its rules in detail.
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- ALPM:
-
Anterolateral papillary muscle
- ASA:
-
American society of anesthesiologists
- ASC:
-
Ascending
- ASD:
-
Atrial septal defect
- ASE:
-
American society of echocardiography
- AV:
-
Aortic valve
- CABG:
-
Coronary artery bypass graft surgery
- CHDs:
-
Complex congenital heart diseases
- CT:
-
Computed tomography
- DESC:
-
Descending
- IVC:
-
Inferior vena cava
- LAX:
-
Long axis
- LE:
-
Lower esophageal
- LV:
-
Left ventricular
- MRI:
-
Magnetic resonance imaging
- PA:
-
Pulmonary artery
- PFO:
-
Patent foramen ovale
- PPM:
-
Posteromedial papillary muscle
- PO-TEE:
-
Perioperative transesophageal echocardiography
- PV:
-
Pulmonic valve
- RVOT:
-
Right ventricular outflow tract
- SAM:
-
Systolic anterior motion
- SAX:
-
Short axis
- TTE:
-
Transthoracic echocardiography
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Left-sided intracavitary air with intramyocardial air as is manifested by apical myocardial echogenicity and brightness. Left: Four-chamber view, Right: Long-axis view (MP4 1979 kb)
Left-sided intracavitary air with intramyocardial air as is manifested by apical myocardial echogenicity and brightness. Left: Four-chamber view, Right: Long-axis view (MP4 1978 kb)
Intraoperative transesophageal echocardiography images of an adult patient after sinus venosus type atrial septal defect repair. Left and middle panels show a significant turbulent flow and an increased gradient, suggestive of the superior vena cava to the right atrial junction stenosis. Right panel: Gradient and turbulent flow decreased after fluid therapy (MP4 993 kb)
Intraoperative transesophageal echocardiography images of an adult patient after sinus venosus type atrial septal defect repair. Left and middle panels show a significant turbulent flow and an increased gradient, suggestive of the superior vena cava to the right atrial junction stenosis. Right panel: Gradient and turbulent flow decreased after fluid therapy (MP4 994 kb)
Systolic anterior motion (SAM) of the anterior mitral valve leaflet associated with posterior directed mitral regurgitation (MP4 1964 kb)
Systolic anterior motion (SAM) of the anterior mitral valve leaflet associated with posterior directed mitral regurgitation (MP4 988 kb)
Fibromuscular sub-aortic valve stenosis (thickness and length of the subvalvular thickening are important because of the systolic anterior motion (SAM) of the anterior mitral valve leaflet and posterior directed mitral regurgitation. These measurements are useful parameters for estimating the extent of the septomymectomy (AVI 21174 kb)
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Sadeghpour, A., Alizadehasl, A. (2018). Perioperative Transesophageal Echocardiography. In: Sadeghpour, A., Alizadehasl, A. (eds) Case-Based Textbook of Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-319-67691-3_29
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DOI: https://doi.org/10.1007/978-3-319-67691-3_29
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