title: Transesophageal echocardiography during cardiac arrest in orthopedic surgery patients: a report of two cases and a review of the literature.
abstract: BACKGROUND
  Cardiac arrest situations represent an enormous clinical challenge to the physicians involved. Research suggests that the utilization on transesophageal echocardiography (TEE) may provide important diagnostic information and allows for institution of more specific treatment, while not hampering resuscitation efforts.
  
  
  METHODS
  In this review, we highlight the usefulness of TEE in cardiac arrest situations in the orthopedic setting, by presenting two perioperative cases. In one case, TEE was used to diagnose intraoperative pulmonary embolism and guide thrombolytic therapy. The second case highlights the use of TEE in management of hemodynamic instability in a patient with aortic stenosis.
  
  
  METHODS
  Memtsoudis et al. showed that in 19 of 22 cardiac arrests, an underlying pathological process could be established with TEE, leading to specific interventions beyond the institution of advanced cardiac life support measures.
  
  
  CONCLUSIONS
  TEE can provide rapid diagnostic information guiding treatment in patients with hemodynamic compromise. The use is expanding beyond the cardiac operating theater and given the potential clinical impact consideration should be given to utilizing this valuable imaging modality in appropriate clinical situation.
authors.affiliation: Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA ; Weill Medical College of Cornell University, New York, NY 10065 USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Garvin
authors.affiliation: Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA ; Weill Medical College of Cornell University, New York, NY 10065 USA.
authors.forename: Ottokar
authors.initials: O
authors.lastname: Stundner
authors.affiliation: Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA ; Weill Medical College of Cornell University, New York, NY 10065 USA.
authors.forename: Stavros G
authors.initials: SG
authors.lastname: Memtsoudis
keywords: cardiac arrest; cardiac complications; embolism; orthopedic surgery; resuscitation; transesophageal echocardiography