The role of peri-operative transoesophageal echocardiography

  • Justiaan Swanevelder University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester
  • Alexander Ng Heart and Lung Centre, Royal Wolverhampton Hospitals NHS Trust, West Midlands


Cardiac surgery and anaesthesia have come a long way since the late 1970s when Transoesophageal Echocardiography (TOE) was introduced into the peri-operative arena. The development of many surgical procedures and the reduction in peri-operative morbidity and mortality can be directly related to the use of TOE. In complicated surgery it has the benefit of providing real time interrogation of cardiac structures and function that can be reliable and repeatable. As with many interventions a full understanding of the limitations, possible artefacts and operating environment is required to benefit patient care. In 1996 an American Society of Anaesthesiologists/Society of Cardiovascular Anaesthesiologists Task Force published guidelines on the indications for intra-operative TOE. These published guidelines have been updated in 2003 and have recently been reviewed once again in the USA and Europe. In this document we discuss the role of peri-operative TOE and its use and value during some Category I procedures.