Document Detail

Multinational institutional survey on patterns of intraoperative transesophageal echocardiography use in adult cardiac surgery.
MedLine Citation:
PMID:  24440009     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: To assess institutional patterns of perioperative transesophageal echocardiography (TEE) usage.
DESIGN: The authors hypothesized that TEE is performed more frequently and comprehensively in academic centers, mainly by anesthesiologists, and barriers to performing TEE are due to inadequate resources. A survey was deployed to selected participants. Collated responses were assessed for demographic patterns in TEE practice, and 2-category comparisons were made with Chi-squared association tests.
SETTING: Web-based survey.
PARTICIPANTS: Practitioners in cardiovascular anesthesia/surgery in 200 institutions.
MEASUREMENTS AND MAIN RESULTS: Surveys were completed by respondents representing 200 centers in 27 countries and 1,727 anesthesiologists with a mean annual institutional volume of 924 cases. Most centers were in the USA (53%) and were defined as academic (83%). Anesthesiologists performed (85%) and also read/reported TEEs (78%) in most centers. Three-dimensional TEE is performed routinely at 40% of centers. TEE is used routinely for valve surgery in 95% of institutions compared to 68% for coronary artery bypass graft surgery. Academic institutions assessed diastolic function more often than nonacademic centers (46% v 19%; p = 0.006). The most important reason cited for not using TEE in all cases was insufficient resource availability (47%).
CONCLUSIONS: These results suggest that TEE is performed more comprehensively in academic centers, mainly by anesthesiologists, and that lack of resources is a significant barrier to routine TEE usage. TEE is used more often for valve surgery than for coronary artery bypass graft surgery, and many centers use 3D TEE. This survey describes international TEE practice patterns and identifies limitations to universal adoption of TEE in cardiac surgery.
Heather A Dobbs; Elliott Bennett-Guerrero; William White; Stanton K Shernan; Alina Nicoara; J Mauricio Del Rio; Mark Stafford-Smith; Madhav Swaminathan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  28     ISSN:  1532-8422     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-01-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  54-63     Citation Subset:  IM    
Copyright Information:
© 2013 Elsevier Inc. All rights reserved.
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