Objective
A new slender, flexible, and miniaturized disposable monoplane transesophageal TEE
probe has been approved for episodic hemodynamic transesophageal echocardiographic
monitoring. The authors hypothesized that episodic monoplane TEE with a limited examination
would help guide the postoperative management of high-risk cardiac surgery patients.
Design
The authors analyzed the initial consecutive observational experience with the miniaturized
transesophageal echocardiography monitoring system (ClariTEE, ImaCor, Uniondale, New
York).
Setting
Single institution in a university setting.
Participants
Unstable cardiac surgery patients.
Interventions
The authors assessed fluid responsiveness, echocardiographic data, and concordance
among hemodynamic data.
Measurements and Main Results
From June 2010 to February 2011, 21 unstable cardiac surgery patients with postoperative
instability were identified. Two patients (10%) required reoperation for bleeding
and tamponade physiology. Right ventricular dysfunction was diagnosed by episodic
TEE monitoring in 7 patients (33%), while hypovolemia was documented in 12 patients
(57%). Volume responsiveness was documented in 11 patients. In this observational
study, discordance between hemodynamic monitoring and episodic TEE was qualitatively
observed in 14 patients (66%).
Conclusion
The authors demonstrated the ability of episodic monoplane TEE to identify discordance
between hemodynamic monitoring to better define clinical scenarios in unstable cardiac
surgery patients. For these challenging patients, limited episodic TEE assessment
has become a cornerstone of ICU care in this institution.
Key Words
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Article info
Footnotes
Drs. Bick, Costello, and Wagner taught echocardiography workshops for ImaCor Inc. in 2012.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
