1. .
Phillip Louis D’Amato.
May 15 ,2014.

2. Intraoperative TEE has been in use since the 1980s.This has been very
effective in improving the overall efficacy of open heart procedures.
Previous studies have conclusively shown that
TEE provides essential real-time data but before ,during ,and after
CABG(Holger,2008).

3. Intraoperative advantages.
 The information can be vital in assessing cardiac
performance ,valve function, great vessel pathology
and congenital anomies that can produce positive
clinical perioperative outcomes(Holger, 2008).
 TEE has been shown to morbidity risk of 0.2 % and
mortality of 0%(An kit, 20012).

4. Research on benefits of TEE.
 A recent study at Brigham and Woman's Hospital
recently revealed some intriguing results on TEE.
 In a study CPB both before and after CPM TEE
examinations influenced surgical decision making in
7.0% and 2.2% respectively of all evulated patients
(n=m12,566)(Holger,2008).

5. TEE benefits of echo.
 Also, in combined cabg and valve procedures, surgical
decisions were influenced by 12.3 % percent of the pre
CPB and 2.2 % percent of the post CPB TEE
examinations (Holger, 2008).

6. TEE views.

7. What is being assessed with TEE?
 The surgeon using the technology will often desire a
focused exam. He or She is mainly concerned with a
few relevant clinical indications.
 TEE is extremely useful in providing both
hemodynamic and structural detail on the heart.
 TEE is vital to a successful surgical outcome in
cardiovascular disease cases.

8. Things to observe in TEE in OR.
 1. Continuous real time observation of left ventricle
function.
 2.Mointoring of valve replacement and hemodynamic
load factors.
 3. Assessment of pericardial space for effusion.
 4.Development of clots or emboli.

9. Indications for use of TEE.
 CABG.
 Valve replacements.
 TAVR.
 High risk surgical patients.
 Intraoperative high risk no cardiac surgical
procedures.

10. Future directions of Intraoperative.
 3D TEE today is becoming a mandatory requirement
for all Cardiovascular procedures in the OR.
 With the invention of TAVR and the Mitral clip the
surgeon must have absolute confidence in the
placement of the mitral clip and that’s one realized
benefit of 3D TEE(Quamruddin, 2011).
 Superior image quality is another benefit of 3D TEE.

11. References.
 1.Ankit, Agrawal.The efficacy of TEE and transthoracic
Echocardiography during Perioperative Cardiovascular
Adverse Events in non cardiac surgery.
 2.Holger,Eltzchig,Rosenberger,Peter,loffler,Michaela,J
Fox.(2008).Ann Thoracic Surgery.85. 845-853.
3.Quamruddin,Salima,Nauvi,Taneem.(2011).Advances
in 3D echocardiography for mitral valve. Expert
review of cardiovascular therapy.9(11).1431-1443.