TEE normal anatomy
Pretest
Question 1
True or False
Detection of regional wall-motion abnormalities (RWMAs) with TEE has been shown
1. to be an earlier and more sensitive sign of ischemia than electrocardiography during cardiovascular surgery.
2. RWMAs that persist to the end of surgery are predictive of poor outcome after cardiac surgery.
3. Most studies evaluating intraoperative regional wall-motion have used a 4-segment model at the mid-papillary level.
4. The 4- and 6-segments could be used to assess the regional wall-motion during the intraoperative period.
TRANSESOPHAGEAL echocardiography (TEE) is commonly used during coronary artery bypass graft surgery to monitor regional cardiac function.
Detection of regional wall-motion abnormalities (RWMAs) with TEE has been shown to be an earlier and more sensitive sign of ischemia than electrocardiography during cardiovascular surgery.
Most studies evaluating intraoperative regional wall-motion have used a 4-segment model at the mid-papillary level.
American Society of Echocardiography (ASE) has published guidelines describing a 16-segment model of the left ventricle, including 6 segments at the mid-papillary level.
The goal is to obtain sufficient detail to characterize the pattern of dysfunction in patients with ischemic heart disease.
The location of the segments follows the perfusion territory of the three major epicardial arteries to facilitate the diagnosis of ischemic dysfunction.
High degree of agreement (scores within 1 grade) between anesthesiologists trained in TEE and an echocardiographer using either a 4- or a 6-segment model (96% and 94%) of the left ventricle at the mid-papillary muscle.
A high intraobserver agreement was also obtained. Moreover, the bias and precision of either the 4- and 6-segments were small between the anesthesiologist and the echocardiographer, indicating that both methods could be used to assess the regional wall-motion during the intraoperative period.
Post test
Question 1
True or False
Detection of regional wall-motion abnormalities (RWMAs) with TEE has been shown
1. to be an earlier and more sensitive sign of ischemia than electrocardiography during cardiovascular surgery.
2. RWMAs that persist to the end of surgery are predictive of poor outcome after cardiac surgery.
3. Most studies evaluating intraoperative regional wall-motion have used a 4-segment model at the mid-papillary level.
4. The 4- and 6-segments could be used to assess the regional wall-motion during the intraoperative period.
Answer:
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