@article{0f8fcda83d8245cf8db27e09c2e7a499,
title = "Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach: From the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons",
abstract = "Intraoperative transesophageal echocardiography is a standard diagnostic and monitoring tool employed in the management of patients undergoing an entire spectrum of cardiac surgical procedures, ranging from “routine” surgical coronary revascularization to complex valve repair, combined procedures, and organ transplantation. Utilizing a protocol as a starting point for imaging in all procedures and all patients enables standardization of image acquisition, reduction in variability in quality of imaging and reporting, and ultimately better patient care. Clear communication of the echocardiographic findings to the surgical team, as well as understanding the impact of new findings on the surgical plan, are paramount. Equally important is the need for complete understanding of the technical steps of the surgical procedures being performed and the complications that may occur, in order to direct the postprocedure evaluation toward aspects directly related to the surgical procedure and to provide pertinent echocardiographic information. The rationale for this document is 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.",
keywords = "Cardiac surgery, Intraoperative, Transesophageal echocardiography",
author = "Alina Nicoara and Nikolaos Skubas and Niv Ad and Alan Finley and Hahn, {Rebecca T.} and Feroze Mahmood and Sunil Mankad and Nyman, {Charles B.} and Francis Pagani and Porter, {Thomas R.} and Kent Rehfeldt and Marc Stone and Bradley Taylor and Annette Vegas and Zimmerman, {Karen G.} and Zoghbi, {William A.} and Madhav Swaminathan",
note = "Funding Information: TEE is instrumental in refining preload, afterload, and inotropic support at separation from CPB by providing anatomic and functional information regarding LV and RV filling and function.AR in patients undergoing LVAD implantation is likely to progress due to lack of aortic valve opening, leaflet fibrosis, and fusion and retraction of the leaflet tips. The International Society of Heart Lung Transplantation recommends correction of moderate or higher degrees of pre-existing AR at the time of LVAD placement, since this may impact the long-term function and durability of the device.70 In patients with advanced heart failure, elevated LV diastolic pressure and reduced systemic vascular resistance combine to reduce the diastolic pressure gradient across the AV, which leads to underestimation of AR severity before LVAD implantation. Re-evaluation of AR should be repeated after institution of CPB when the LV is decompressed and there is direct flow into the ascending aorta through the aortic cannula, which may mimic to some degree the hemodynamic conditions during LVAD support. The following authors reported relationships with one or more commercial interests: Rebecca T. Hahn, MD, FASE reports speaker fees from Boston Scientific Corporation, Baylis Medical, Edwards Lifesciences and Medtronic; consulting for Abbott Structural, Edwards Lifesciences, Gore & Associates, Medtronic, Navigate, and Philips Healthcare; non-financial support from 3mensio; equity with Navigate; and is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored trials, for which she receives no direct industry compensation. Charles B. Nyman, MBBCh, received educational honoraria from Edwards Lifesciences Ltd. and Baylis Medical, and owns common stock in Edwards Lifesciences Ltd. Thomas R. Porter, MD, FASE, received grant and equipment support from Philips Research North America and General Electric Global Research, and research support from Lantheus Medical Imaging and Astellas Pharma, Inc. Funding Information: The following authors reported relationships with one or more commercial interests: Rebecca T. Hahn, MD, FASE reports speaker fees from Boston Scientific Corporation, Baylis Medical, Edwards Lifesciences and Medtronic; consulting for Abbott Structural, Edwards Lifesciences, Gore & Associates, Medtronic, Navigate, and Philips Healthcare; non-financial support from 3mensio; equity with Navigate; and is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored trials, for which she receives no direct industry compensation. Charles B. Nyman, MBBCh, received educational honoraria from Edwards Lifesciences Ltd. and Baylis Medical, and owns common stock in Edwards Lifesciences Ltd. Thomas R. Porter, MD, FASE, received grant and equipment support from Philips Research North America and General Electric Global Research, and research support from Lantheus Medical Imaging and Astellas Pharma, Inc. Publisher Copyright: {\textcopyright} 2020 American Society of Echocardiography Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
month = jun,
doi = "10.1016/j.echo.2020.03.002",
language = "English (US)",
volume = "33",
pages = "692--734",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "6",
}