Perioperative transesophageal echocardiography: State of the art 2016

Perioperative transesophageal echocardiography: State of the art 2016 the life-threatening situation readily with perioperative TEE thereby negating the need for the use of radio-opaque contrast and enabling for surgery to be planned promptly. In addition, biventricular and valvular function can be assessed rapidly with the use of perioperative TEE in such scenarios. Surgical and hybrid operating rooms Perioperative TEE is performed routinely in CV surgery ORs in valvular heart diseases and thoracic aortic surgical procedures. [3] However, for valvular heart disease cases, the severity of regurgitant lesions is partly dependent on loading conditions. Therefore, the conventional thinking and recommendations by the current guidelines are that one should not evaluate the severity of valvular regurgitation under anesthesia in OR. Other uses of perioperative TEE are in cases of coronary artery bypass grafting for assessment of biventricular function and in select cases of noncardiac surgery. In addition, perioperative TEE is frequently employed for prompt recognition of retained air and thorough examination of de-airing techniques. [4] The rare but commonly lethal iatrogenic development of bronchopulmonary vein fistula can also be detected during perioperative TEE. Mitral valve surgeries Mitral valve (MV) anatomy can be assessed in OR at the time of surgery to assess its suitability for repair versus replacement. In patients with functional mitral regurgitation (MR) undergoing undersized annuloplasty, recurrent MR is seen in ~70% of patients at 5 years.