title: Perioperative transoesophageal echocardiography: current status and future directions.
abstract: Transoesophageal echocardiography (TOE) is used in the perioperative arena to monitor patients during life-threatening emergencies, cardiac and high-risk non-cardiac surgeries. It provides qualitative and quantitative information on valvular and ventricular functions, and dynamic cardiac anatomy can be displayed with a physiological perspective. This technology has evolved from two-dimensional (2D) to the ready availability of real-time three-dimensional (RT-3D) imaging in the operating rooms. Enhanced spatial and temporal resolutions with 3D imaging have most significantly impacted the quality of intraoperative surgical valve repair and replacement decisions. Additionally, 3D imaging has facilitated the advent of minimally invasive and percutaneous interventions for structural heart disease. Information derived from TEE is routinely used to evaluate a patient's suitability for an intervention, provide guidance during the intervention and eventually comment on the quality and success of the procedure. Expertise in perioperative TEE is an integral component of a cardiac anaesthesiologist's skill sets. With structural heart disease interventions becoming more minimally invasive, the intraoperative guidance provided by TEE will continue to be a critical component of these procedures. With improving computational and processing power, the expectations from TEE will continue to be incremental in the perioperative arena.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Feroze
authors.initials: F
authors.lastname: Mahmood
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Stanton Keith
authors.initials: SK
authors.lastname: Shernan
mesh_terms: D004059:Diffusion of Innovation; D018618:Echocardiography, Doppler, Color / Q000266:history / Q000639:trends; D019560:Echocardiography, Three-Dimensional / Q000266:history / Q000639:trends; D017548:Echocardiography, Transesophageal / Q000266:history / Q000639:trends; D005544:Forecasting; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D019990:Perioperative Care / Q000266:history / Q000379:methods* / Q000639:trends; D011237:Predictive Value of Tests; D015203:Reproducibility of Results