ASE Defines TEE Practice Standards

May 1, 2013, Morrisville, NC: The American Society of Echocardiography (ASE) released a new consensus document today focusing on basic TEE examinations. Basic Perioperative Transesophageal Echocardiography Examination: A Consensus Statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists will appear in the May issue of the Journal of the American Society of Echocardiography ( JASE ).

Created in response to continuing developments and changes in technology and medical practices, this new consensus statement brings the medical community up to date and defines where a basic TEE echo, versus a more advanced one, is needed for best patient care. Identifying what practices should be considered outside the scope of conducting a basic TEE echo was the key driver and most important benchmark behind the development of this new document.

Scott T. Reeves, MD, MBA, FASE, The John E. Mahaffey, MD Professor and Chairman, Anesthesia & Perioperative Medicine at the Medical University of South Carolina, chair of ASE’s Council of Perioperative Echocardiography (COPE), served as the lead author of this guideline. “It is my pleasure to announce this new document to the medical community. ASE considers this a pivotal document, summarizing and clarifying the scope of basic perioperative transesophageal echocardiography (PTE). The ASE has a long history of being committed to defining what is appropriate for the scope of echocardiography and fully supports this new concept. Prior to the development of this document, the education, training and views of a basic PTE examination were disseminated across multiple organization’s guideline documents. For the first time, an anesthesiologist will be able to delineate all the components of a basic PTE examination from a single document, making it a critical resource as one prepares for patient care and taking the National Board of Echocardiography’s basic certification examination.”

This consensus statement will change practice for anesthesiologists by educating and encouraging training in the significant role of a basic perioperative transesophageal (PTE) cardiac examination in the care and treatment of the unstable surgical patient. Perioperative care is the care that is given before, during and after surgery. The principal goal of a basic PTE examination is intraoperative monitoring and should focus on cardiac causes of hemodynamic or ventilatory instability including ventricular size and function, valvular anatomy and function, volume status, pericardial abnormalities and complications from invasive procedures, as well as the clinical impact or etiology of pulmonary dysfunction.

Information obtained during the intraoperative basic PTE evaluation will be used to initiate therapies for any derangements identified, and is expected to improve patient care.

Dr. Patricia A. Pellikka, a cardiologist at Mayo Clinic and ASE’s President, stated “This document was written as a collaborative effort by representatives from the ASE and SCA. It details the basic perioperative transesophageal echocardiography examination and the requisite training to perform it. This basic exam is appropriate for assessment of the general cause of hemodynamic instability in surgical patients without known or suspected complex pathology. It is a step forward in the promotion of best practices of care for our patients.”

The full document will be available on the Journal of American Society of Echocardiography ( JASE ) Website ( www.onlinejase.com ) on May 1 and will be published in the May 2013 print issue. This consensus document and all ASE guideline documents are also available to the medical community at www.asecho.org/guidelines .

As the largest global organization for cardiovascular ultrasound imaging, the American Society of Echocardiography (ASE) is the leader and advocate in setting practice standards and guidelines. Comprised of over 16,000 physicians, sonographers, nurses, and scientists, ASE is a strong voice providing guidance, expertise, and education to its members with a commitment to improving the practice of ultrasound and imaging of the heart and cardiovascular system for better patient outcomes. Full text of ASE’s guidelines is available at www.asecho.org/guidelines . For more information about ASE, visit www.asecho.org or ASE’s public information site, www.SeeMyHeart.org .

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Furthermore, the American Society of Echocardiography Guidelines for Performing a Comprehensive Multiplane Transesophageal Examination, under the leadership of Rebecca T. Hahn, MD, FASE as chair, is currently being reviewed by the ASE Guidelines and Standards committee. This document is a critical expansion and revision of the 1999 ASE/SCA Guidelines for Performing a Comprehensive Intraoperative Multiplane Transesophageal Echocardiography Examination: Recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography document. Over the past 14 years, the field of perioperative echocardiography has exploded with new technology and procedures being performed. This has led to the need to update the original document and to significantly increase the number of transesophageal echocardiography views needed to perform a comprehensive examination. I know we are all looking forward to this document being published.