Transoesophageal Echocardiography: Clinical Assessment, Techniques and Procedures in Critical Care and ICU

  • F. Guarracino
  • C. Cariello
Conference paper


Transoesophageal echocardiography (TOE) was introduced into the operating room in the late 1980s as a tool for monitoring the left ventricle (LV) and for supporting the haemodynamic management of patients during general anaesthesia.


Right Ventricular Infective Endocarditis Aortic Dissection Right Ventricular Outflow Tract Right Ventricular Dysfunction 
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  1. 1.
    Kneeshaw J, Canty D, Roscoe A et al (2006) Peri-operative TOE — does it have an effect on surgical practice. J Br Soc Echocardiogr 55:7–8Google Scholar
  2. 2.
    Practice Guidelines for Perioperative Transesophageal Echocardiography (1996) A report by the American Society of Anesthesiologists and Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Anesthesiology 84:986–1006Google Scholar
  3. 3.
    Shanewise JS, Cheung AT, Savino JS et al (1999) ASE/SCA Guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for intraoperative echocardiography, the Society of Cardiovascular Anesthesiologists Task Force for certification in perioperative transesophageal echocardiography. Anesth Analg 89:870–884PubMedCrossRefGoogle Scholar
  4. 4.
    Poelaert JI, Trouerbach J, De Buyzere M et al (1995) Evaluation of transesophageal echocardiography as a diagnostic and therapeutic aid in a critical care setting. Chest 107:774–779PubMedCrossRefGoogle Scholar
  5. 5.
    Guidelines for the diagnosis and treatment of chronic heart failure (2001) Task force report. European Heart Journal 22:1527–1560Google Scholar
  6. 6.
    Seeberger MD, Cahalan MK, Rouine-Rapp K et al (1997) Acute hypovolemia may cause segmental wall motion abnormalities in the absence of myocardial ischemia. Anesth Analg 85:1252–1257PubMedCrossRefGoogle Scholar
  7. 7.
    Comunale ME, Body SC, Ley C et al (1998) The concordance of intraoperative left ventricle wall motion abnormalities and electrocardiographic S-T segment changes: association with outcome after coronary revascularization. Multicenter Study of Perioperative Ischemia Research Group. Anesthesiology 88:945–954PubMedCrossRefGoogle Scholar
  8. 8.
    Simmons LA, Weidemann F, Sutherland GR et al (2002) Doppler tissue velocity, strain, and strain rate imaging with transesophageal echocardiography in the operating room: a feasibility study. J Am Soc Echocardiogr 15:768–776PubMedCrossRefGoogle Scholar
  9. 9.
    Hartmann T, Kolev N, Blaicher A et al (1997) Validating of acoustic quantification colour kinesis for detection of left ventricular regional wall motion abnormalities: a transoesophageal echocardiography study. Br J Anaesth 79:482–487PubMedGoogle Scholar
  10. 10.
    Poelaert J, Schmidt C, Van Aken H et al (1999) A comparison of transoesophageal echocardiographic Doppler across the aortic valve and the thermodilution technique for estimating cardiac output. Anaesthesia 54:128–136PubMedCrossRefGoogle Scholar
  11. 11.
    Poortmans G, Schupfer G, Roosens C et al (2000) Transesophageal echocardiographic evaluation of left ventricular function. J Cardiothorac Vasc Anesth 14:588–598PubMedCrossRefGoogle Scholar
  12. 12.
    European Study Group on Diastolic Heart Failure (1998) How to diagnose diastolic heart failure. Eur Heart J 19:990–1003CrossRefGoogle Scholar
  13. 13.
    Garcia MJ, Thomas JD, Klein AL (1998) New doppler echocardiographic applications for the study of diastolic function. J Am Coll Cardiol 32:865–875PubMedCrossRefGoogle Scholar
  14. 14.
    Groban L, Dolinski SY (2005) Transesophageal echocardiographic evaluation of diastolic function. Chest 128:3652–3663PubMedCrossRefGoogle Scholar
  15. 15.
    Denslow S, Wiles HB (1998) Right ventricular volumes revisited: a simple model and simple formula for echocardiographic determination. J Am Soc Echocardiogr 11:864–873PubMedCrossRefGoogle Scholar
  16. 16.
    Poelaert JL, Visser CA, Everaert JA et al (1993) Acute hemodynamic changes of pressure-controlled inverse ratio ventilation in the adult respiratory distress syndrome. A transesophageal echocardiographic and Doppler study. Chest 104:214–219PubMedCrossRefGoogle Scholar
  17. 17.
    Bernard Y, Meneveau N, Vuillemenod A et al (1997) Planimetry of aortic valve area using multiplane transoesophageal echocardiography is not a reliable method for assessing severity of aortic stenosis. Heart 78:68–73PubMedGoogle Scholar
  18. 18.
    Agricola E, Oppizzi M, Francesco Malsano F et al (2004) Echocardiographic classification of chronic ischemic mitral regurgitation caused by restricted motion according to tethering pattern. Eur J Echocardiography 5:326–334CrossRefGoogle Scholar
  19. 19.
    Levine RA, Schwammenthai E (2005) Ischemic mitral regurgitation on the threshold of a solution: from paradoxes to unifying concepts. Circulation 112:745–758PubMedCrossRefGoogle Scholar
  20. 20.
    Kinnaird TD, Thompson CR, Munt BI (2001) The deceleration [correction of declaration] time of pulmonary venous diastolic flow is more accurate than the pulmonary artery occlusion pressure in predicting left atrial pressure. J Am Coll Cardiol 37:2025–2030PubMedCrossRefGoogle Scholar
  21. 21.
    Garcia MJ, Ares MA, Asher C et al (1997) An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure. J Am Coll Cardiol 29:448–454PubMedCrossRefGoogle Scholar
  22. 22.
    Greim CA, Roewer N, Apfel C et al (1997) Relation of echocardiographic preload indices to stroke volume in critically ill patients with normal and low cardiac index. Intensive Care Med 23:411–416PubMedCrossRefGoogle Scholar
  23. 23.
    Yamamuro A, Yoshida K, Hozumi T et al (1999) Noninvasive evaluation of pulmonary capillary wedge pressure in patients with acute myocardial infarction by deceleration time of pulmonary venous flow velocity in diastole. J Am Coll Cardiol 34:90–94PubMedCrossRefGoogle Scholar
  24. 24.
    McConnell MV, Solomon SD, Rayan ME et al (1996) regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol 78:469PubMedCrossRefGoogle Scholar
  25. 25.
    Pruszczyk P, Torbicki A, Kuch-Wocial A et al (2001) Diagnostic value of transoesophageal echocardiography in suspected haemodynamically significant pulmonary embolism. Heart 85:628PubMedCrossRefGoogle Scholar
  26. 26.
    Erbel R, Daniel W, Visser C et al (1989) Echocardiography in diagnosis of aortic dissection. Lancet 1:457–461PubMedCrossRefGoogle Scholar
  27. 27.
    Vignon P, Rambaud G, Francois B et al (1998) Quantification of traumatic hemomediastinum using transesophageal echocardiography: impact on patient management. Chest 113:1475–1480PubMedCrossRefGoogle Scholar
  28. 28.
    Goarin JP, Cluzel P, Gosgnach M et al (2000) Evaluation of transesophageal echocardiography for diagnosis of traumatic aortic injury. Anesthesiology 93:1373–1377PubMedCrossRefGoogle Scholar
  29. 29.
    Tsang TS, Barnes ME, Hayes SN et al (1999) Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management: Mayo Clinical experience 1979–1998. Chest 116:322PubMedCrossRefGoogle Scholar
  30. 30.
    Ozier Y, Gueret P, Jardin F et al (1984) Two-dimensional echocardiographic demonstration of acute myocardial depression in septic shock. Crit Care Med 12:596–599PubMedCrossRefGoogle Scholar
  31. 31.
    Groeneveld ABJ, Nauta JJ, Thijs L (1988) Peripheral vascular resistance in septic shock: its relation to outcome. Intensive Care Med 14:141–147PubMedCrossRefGoogle Scholar
  32. 32.
    Practice parameters for hemodynamic support of sepsis in adult patients in sepsis (1999) Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med 27:639–660Google Scholar
  33. 33.
    Vieillard-Baron A, Prin S, Chergui K et al (2003) Hemodynamic instability in sepsis bedside assessment by Doppler echocardiography. Am J Respir Crit Care Med 168:1270–1276PubMedCrossRefGoogle Scholar
  34. 34.
    Jardin F, Dubourg O, Bourdarias JP (1997) Echocardiographic pattern of acute cor pulmonale. Chest 111:209–217PubMedCrossRefGoogle Scholar
  35. 35.
    Durack DT, Lukes AS, Bright DK et al (1994) New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke endocarditis service. Am J Med 96:200–209PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • F. Guarracino
    • 1
  • C. Cariello
    • 1
  1. 1.Department of Cardiothoracic Anaesthesia and Intensive CareAzienda Ospedaliera Universitaria PisanaPisaItaly

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