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The dark side of the moon-
Transesophageal
echocardiography
Massimiliano Meineri MDAssociate Professor of Anesthesiology
University of Toronto
Staff Anesthesiologist
Director Perioperative Echocardiography
Toronto General Hospital
Disclosures
• APIL funding from PMCC Foundation
Objectives
• Review of rationale
• Challenges
• Evidence
• Guidelines
• New trends
TTE TEE
Indications
Indications
Technically challenging studies…
• Post surgical
• Mechanically ventilated
• Supine
• Dressings
• Obese
• Full stomach
• Prone
• Subcutaneous emphysema
Indications
Indications
Indications
Indications
Equipment
Safety
Cotu G, Denault A. CJA
Safety
Safety
http://pie.med.utoronto.ca/TEE/
Indications
28 Views
3D
Comprehensive
assessment
11 Views
LV/RV Assessment
Hypovolemia
PE
Basic Valvular
Air
Thoracic trauma
Effusion
Certification
Certification
Certification
TTE TEE
8 Views 17 views
Certification
Summary
• The dark side of the moon-Transesophageal
echocardiography
Competency
31.5
Hemodynamic Monitoring
Hemodynamic Monitoring
Competency
32.5 vs. 13.6
Rotation
hTEE
hTEE
hTEE
Objectives
• The dark side of the moon-Transesophageal
echocardiography
Objectives
• The dark side of the moon-Transesophageal
echocardiography
Hemodynamic Monitoring
Hemodynamic Monitoring
Summary
• Technology developments
• Good safety profile
• Favourable learning curves
• Key role for simulation
• Focused TEE?
