AN INTRODUCTION TO TRANSESOPHAGEAL ECHOCARDIOGRAPHY .2. CLINICAL-APPLICATIONS

Purpose: As progress has been made in the acquisition of cardiac image s with transoesophageal echocardiography, the technique has moved from the confines of the cardiology laboratory into the operating room, th e intensive care unit, and the emergency department. This has afforded anaesthetists the opportunity to become familiar with, and develop ex pertise in its practice. The purpose of this article is to present a r eview of transoesophageal echocardiography with reference to anaesthet ic practice. Source: The principle source of material was a computeriz ed Medline(TM) search of the English language literature from 1986 to 1995. Principle findings: After discussing the technique of probe inse rtion, and describing some of the standard images, transoesophageal ec hocardiography's clinical utility is critically assessed. Comparisons with available monitoring techniques are made with reference to ventri cular function, valvular heart disease, pericardial, aortic and congen ital heart disease, and the management of the multiple traumatized pat ient. Issues of certification and maintenance of competence are also d iscussed. Conclusion: Although the benefit of transoesophageal echocar diography is intuitive in many clinical situations, in others, it has not been shown to improve upon presently existing monitoring technique s. The need for adequate training and collaboration with cardiology co lleagues is emphasized.