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Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach
From the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons

pdf :  Surgical guidelines TEE JASE 2020

Alina Nicoara, Chair, MD, FASE, Nikolaos Skubas, Co-Chair, MD, DSc, FASE, Niv Ad, MD, Alan Finley, MD, FASE, Rebecca T. Hahn, MD, FASE, Feroze Mahmood, MD, FASE, Sunil Mankad, MD, FASE, Charles B. Nyman, MBBCh, Francis Pagani, MD, PhD, Thomas R. Porter, MD, FASE, Kent Rehfeldt, MD, FASE, Marc Stone, MD, Bradley Taylor, MD, MPH, Annette Vegas, MD, FRCPC, FASE, Karen G. Zimmerman, BS, ACS, RDCS (AE, PE), RVT, FASE, William A. Zoghbi, MD, FASE, and Madhav Swaminathan, MD, FASE, Durham, North Carolina; Cleveland, Ohio; Silver Spring and Baltimore, Maryland; Charleston, South Carolina; New York, New York; Boston, Massachusetts; Rochester, Minnesota; Ann Arbor and Traverse City, Michigan; Omaha, Nebraska; York, Pennsylvania; Toronto, Ontario, Canada; Houston, Texas

Intraoperative transesophageal echocardiography is a standard diagnostic and monitoring tool employed in the man- agement of patients undergoing an entire spectrum of cardiac surgical procedures, ranging from ‘‘routine’’ surgical coronary revascularization to complex valve repair, combined procedures, and organ transplantation. Utilizing a pro- tocol as a starting point for imaging in all procedures and all patients enables standardization of image acquisition, reduction in variability in quality of imaging and reporting, and ultimately better patient care. Clear communication of the echocardiographic findings to the surgical team, as well as understanding the impact of new findings on the surgical plan, are paramount. Equally important is the need for complete understanding of the technical steps of the surgical procedures being performed and the complications that may occur, in order to direct the postprocedure evaluation toward aspects directly related to the surgical procedure and to provide pertinent echocardiographic information. The rationale for this document is to outline a systematic approach describing how to apply the existing guidelines to questions on cardiac structure and function specific to the intraoperative environment in open, minimally invasive, or hybrid cardiac surgery procedures. (J Am Soc Echocardiogr 2020;33:692-734.)

Keywords: Intraoperative, Transesophageal echocardiography, Cardiac surgery