Clinical Sections

Cardiac Anesthesia

Transesophageal Echocardiography

The use of intraoperative transesophageal echocardiography (TEE) has become standard of care for patients undergoing cardiac surgery at Yale New Haven Hospital. The perioperative health care team relies on this service to provide intraoperative information on cardiac, valvular and aortic structure and function. Intraoperative studies are archived and are made available as a valuable resource for University and community cardiologists during postoperative follow up. In addition to the state of the art technology that is in current use, all of our full time staff in the Cardiac Section are certified by National Board Examination in perioperative TEE. In addition to its routine use in cardiac surgery, intraoperative TEE has also been introduced into major vascular and other noncardiac surgeries.

Research activities in TEE continue with an interest in three dimensional reconstruction of mitral annular motion; epidemiologic studies of gender differences and outcome; clinical utility of TEE; renal flow and perfusion during surgery using intravascular and contrast echocardiography; evaluation of ventricular function using automated border detection; evaluation of wall motion abnormalities using color kinesis; evaluation of aortic atheroma and neurological outcome using epiaortic imaging. New ultrasound technology promises to further revolutionize the field of intraoperative TEE. The availability of intravenous myocardial contrast agents will permit the routine assessment of the adequacy of revascularization prior to leaving the operating room. Three-dimensional reconstruction, intravascular ultrasound, intracardiac ultrasound, and improvements in imaging technology will further establish the routine use of TEE during cardiac and major vascular surgery.