title: Intraoperative transesophageal echocardiography during noncardiac surgery.
abstract: OBJECTIVE
  To investigate the use and impact of transesophageal echocardiography (TEE) during noncardiac surgery.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A university teaching hospital.
  
  
  METHODS
  The medical records and the videotapes of 123 intraoperative TEE examinations were reviewed.
  
  
  RESULTS
  TEE was used for non-consultative indications in 68 patients and in consultation in 55 patients. Information that would not have been detected intraoperatively by other means included intracardiac defects, valvular and aortic pathology, the presence or absence of ventricular dysfunction or intracardiac thrombi, and embolization during surgery. Findings during the initial TEE examination and the TEE evaluation of intraoperative events resulted in a major impact on patient management in 15% of patients. The majority of patients in whom TEE had any impact (the sum of major, minor, and limited impact groups) were classified as American Society of Anesthesiologists (ASA) class 3 or 4. Patients in whom TEE had any impact were significantly older than patients in whom TEE had no impact (66.5 +/- 13.4 years v 58.1 +/- 16.2 years; p < 0.05). No patient experienced a complication related to intraoperative TEE.
  
  
  CONCLUSIONS
  It appears that TEE in patients undergoing noncardiac surgery is efficacious in rapidly disclosing new findings and information during periods of hemodynamic instability. It may have a significant impact on intraoperative patient management and may be beneficial in patients older than 66 years of age.
authors.affiliation: Department of Anesthesiology, Mount Sinai Medical Center, New York, NY, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Suriani
authors.forename: S
authors.initials: S
authors.lastname: Neustein
authors.forename: L
authors.initials: L
authors.lastname: Shore-Lesserson
authors.forename: S
authors.initials: S
authors.lastname: Konstadt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011897:Random Allocation; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D016276:Ventricular Function