the dark side of the moon- transesophageal echocardiography...the dark side of the...

The dark side of the moon-

Transesophageal

echocardiography

Massimiliano Meineri MDAssociate Professor of Anesthesiology

University of Toronto

Staff Anesthesiologist

Director Perioperative Echocardiography

Toronto General Hospital

Disclosures

• APIL funding from PMCC Foundation

Objectives

• Review of rationale

• Challenges

• Evidence

• Guidelines

• New trends

TTE TEE

Indications

Indications

Technically challenging studies…

• Post surgical

• Mechanically ventilated

• Supine

• Dressings

• Obese

• Full stomach

• Prone

• Subcutaneous emphysema

Indications

Indications

Indications

Indications

Equipment

Safety

Cotu G, Denault A. CJA

Safety

Safety

http://pie.med.utoronto.ca/TEE/

Indications

28 Views

3D

Comprehensive

assessment

11 Views

LV/RV Assessment

Hypovolemia

PE

Basic Valvular

Air

Thoracic trauma

Effusion

Certification

Certification

Certification

TTE TEE

8 Views 17 views

Certification

Summary

• The dark side of the moon-Transesophageal

echocardiography

Competency

31.5

Hemodynamic Monitoring

Hemodynamic Monitoring

Competency

32.5 vs. 13.6

Rotation

hTEE

hTEE

hTEE

Objectives

• The dark side of the moon-Transesophageal

echocardiography

Objectives

• The dark side of the moon-Transesophageal

echocardiography

Hemodynamic Monitoring

Hemodynamic Monitoring

Summary

• Technology developments

• Good safety profile

• Favourable learning curves

• Key role for simulation

• Focused TEE?

Thank you!

http://pie.med.utoronto.ca/TEE/

www.tghperioptee.ca

Massimiliano.Meineri@uhn.ca