WHO USES TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE OPERATING-ROOM

A survey was made of 155 anesthesiology residency programs in the Unit ed States to determine the patterns of use, responsibility for interpr etation, and training of those responsible for intraoperative transeso phageal echocardiography (TEE). Survey questions included numbers and types of cases for which TEE is used, who interprets TEE data and how they are trained, the extent of resident training in TEE, and beliefs about the utility of TEE. One hundred eight completed surveys were ret urned (70% response). Of those responding, 98 (91%) use intraoperative TEE. In 53 of those 98 institutions (54%), an anesthesiologist was pr imarily responsible for the interpretation of TEE data, whereas a card iologist was responsible in the remainder. Approximately 35% of anesth esiologists using TEE had training in its use during residency or fell owship; the remainder were trained after finishing residency or fellow ship. Forty-two percent of anesthesiologists who use TEE leave a forma l interpretation on the chart apart from the anesthesia record, and 43 % bill specifically for performing TEE. Although 69% of those respondi ng thought that formal credentials should be required for anesthesiolo gists to use intraoperative TEE, only 32% reported that their institut ions actually mandated this. 38% of those responding stated that they offer a dedicated TEE rotation to their residents, and 13% thought tha t their graduating residents were trained well enough to use TEE on th eir own. Among academic institutions responding, the use of intraopera tive TEE is nearly universal, responsibility for its interpretation is split almost evenly between cardiologists and anesthesiologists, and there is a disparity between opinions and reality with regard to TEE c redentialing for anesthesiologists.