26. Transoesophageal Echocardiography

Question 1

Indications for performing TOE

Answer 1

Pre-Op

Periop

Question 2

Pre-Op

Post op

Answer 2

Assess cardiac function where TTE not feasible
- obesity /severe COPD

Assessment cardiac valves of vegetations in sepsis

Aortic dissection dx

Placemet of assist devices
- VAD

Assessment of cardiac collections
-posteriorly located

Question 3

Periop

Answer 3

Assessment Cardiac structural function post cardiac surgery

• Post bypass contractility
• post valve repair / replace
• post surgery for HOCM / Aneurysm

Assessment of LV fxn in sudden collapse

• explanation is unclear
• response to resus poor

Assessment of suspect acute embolic phenomenon

Cardiac response to surgical interventions
- probe left in situ preop allowing temporal comparison

Monitor for ischaemia
high risk patients of cardiac event in NCS

Detection air emboli in neurosurg

Question 4

Complications of TOE

Answer 4

Sore throat

Dental injury

Displacement of airway devices

Vocal cord damage

Thermal injury

Oesophageal perforation (rare absence pre existing)

Burns from diathermy

Arrythmia

Infection

Question 5

Outline Specific information obtained during TOE
+
Why benefit to patient

Answer 5

HR rate & Rhythm

Assessment of filling status and response to filling

CO

Presence RWMA
+ response to Rx

Function + flow across valves

Presence of extracardiac collection
pericardial
pleural

Volume intracardiac air
emboli

Detailed images poster structure heart
Aorta / Atria