If Intraoperative Transesophageal Echocardiography Impacts Outcomes, Why Is Use So Variable?

Emerging evidence suggests that the use of intraoperative transesophageal echocardiography (iTEE) impacts cardiac surgical outcomes and intraoperative decision making. Previous studies have demonstrated a reduction in odds of 30-day mortality, reoperation, and stroke. 1 MacKay E.J. Zhang B. Augoustides J.G. et al. Association of intraoperative TEE and clinical outcomes after open cardiac valve or proximal aortic surgery. JAMA Network Open. 2022; 5e2147820 Crossref Scopus (6) Google Scholar , 2 Nowrangi S.K. Connolly H.M. Freeman W.K. Click R.L. Impact of intraoperative transesophageal echocardiography among patients undergoing aortic valve replacement for aortic stenosis. J Am Soc Echocardiogr. 2001; 14: 863-866 Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar , 3 Metkus T.S. Thibault D. Grant M.C. et al. Transesophageal echocardiography in patients undergoing coronary artery bypass graft surgery. J Am Coll Cardiol. 2021; 78: 112-122 Crossref PubMed Scopus (14) Google Scholar Additionally, various studies have demonstrated the use of iTEE can impact intraoperative decisions in 9% to 11% of surgical procedures, 2 Nowrangi S.K. Connolly H.M. Freeman W.K. Click R.L. Impact of intraoperative transesophageal echocardiography among patients undergoing aortic valve replacement for aortic stenosis. J Am Soc Echocardiogr. 2001; 14: 863-866 Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar ,4 Shapira Y. Vaturi M. Weisenberg D.E. et al. Impact of intraoperative transesophageal echocardiography in patients undergoing valve replacement. Ann Thorac Surg. 2004; 78 ([discussion: 583-584]): 579-583 Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar including isolated coronary artery bypass grafting (CABG), valve, and combined operations. Predictors of Intraoperative Echocardiography: Analysis of The Society of Thoracic Surgeons DatabaseThe Annals of Thoracic SurgeryVol. 115Issue 5PreviewIntraoperative transesophageal echocardiography (TEE) is associated with improved outcomes after cardiac surgery, but unexplained practice pattern variation exists. This study aimed to identify and quantify the predictors of intraoperative TEE use among patients undergoing isolated coronary artery bypass graft surgery (CABG) or cardiac valve surgery. Full-Text PDF