Transoesophageal Echocardiography in Anaesthesia

Ultrasound was not used for imaging of the human heart until 1954, but from this time there has been tremendous progress in ultrasound technology and its application for examining the heart and great vessels. There is no doubt that the introduction of echocardiography into clinical practice represents one of the most important medical achievements of the past century. However, in the early days of echocardiography, the quality of transthoracic images was poor compared with present standards, and cardiologists often encountered a patient whose chest was impenetrable to the ultrasound waves. Thus, it is not surprising that they looked for a new window onto the heart that was not obscured by the air in the lungs or bony structures of the chest wall. Finally, in 1975, Dr Lee Frazin discovered this window in the oesophagus

Since cardiologists were not always available to perform the diagnostic TOE procedures in the operating room, the opportunity for a new role as an echocardiographer emerged for anaesthetists and, subsequently, many of them took it. In the early days of TOE, this created a violent controversy within the anaesthesiology community. The "anaesthetist echocardiographers" were called irresponsible "cowboys" and asked to "keep the scopes in their holsters". Fortunately, these times are overcritical anaesthesia and at the same time perform TOE. One should be aware that TOE as a monitoring and diagnostic tool is an integral part of anaesthetic management, particularly in critical situations. In our opinion it is, in most cases, appropriate that the anaesthesia team be responsible for both anaesthesia and TOE. However, there will always be situations when assistance from a cardiologist will be needed and welcome. This approach is common practice in our institutions

Book details:
Author:Jan Poelaert,Karl Skarvan
Publisher:BMJ Publishing Group
Pages:243
Size:8.72 MB
Format:HTML Complied file

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