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Book Details
Abstract
From basic concepts to state-of-the-art techniques, Perioperative Transesophageal Echocardiography: A Companion to Kaplan's Cardiac Anesthesia helps you master everything you need to know to effectively diagnose and monitor your cardiothoracic surgery patients. Comprehensive coverage and unsurpassed visual guidance make this companion to KaplanÂ’s Cardiac Anesthesia a must for anesthesiologists, surgeons, and nurse anesthetists who need to be proficient in anesthesia care.
 "a powerful learning tool." Reviewed by: JH Rosser and GH Mills, Sheffield on behalf of British Journal of Anaesthesia, December 2015
- Recognize the Transesophageal Echocardiography (TEE) images you see in practice by comparing them to abundant 2D and 3D images, as well as an extensive online library of moving (cine) images.
- Learn from acknowledged leaders in the field of cardiac anesthesiology - Drs. David L. Reich and Gregory W. Fischer.
- See how to address specific clinical situations with detailed case studies and discussions of challenging issues.
- Access the complete contents and videos online at Expert Consult.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | IFC | ||
| PERIOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY: A companion to Kaplan’s Cardiac Anesthesia | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| CONTRIBUTORS | vii | ||
| CONTENTS | xiii | ||
| Section I - Principles and the Normal Heart | 1 | ||
| 1 - Getting Started with Echocardiography: The Twenty Standard Views | 2 | ||
| ?TEE: Indications, Complications, Probe Insertion, and Manipulation | 2 | ||
| ?The Twenty Standard Views | 3 | ||
| References | 13 | ||
| 2 - Principles and Physics: Principles of Ultrasound | 14 | ||
| ?Ultrasound Beam | 14 | ||
| ?Attenuation, Reflection, and Scatter | 15 | ||
| ?Imaging Techniques | 15 | ||
| ?Resolution | 17 | ||
| References | 17 | ||
| 3 - Principles and Physics: Principles of Doppler Ultrasound | 18 | ||
| ?The Doppler Principle | 18 | ||
| ?Pulsed Wave Doppler (PWD) | 18 | ||
| ?High Pulse Repetition Frequency Doppler (HPRF) | 19 | ||
| ?Color Flow Doppler (CFD) | 19 | ||
| ?Continuous Wave Doppler (CWD) | 19 | ||
| ?Determination of Tissue Movement: Tissue Doppler and Speckle Analysis | 20 | ||
| References | 20 | ||
| 4 - Principles and Physics: Equations to Remember (the Bernoulli Equation, Velocity-Time Integrals, and the Continuity Equation) | 21 | ||
| ?The Bernoulli Equation | 21 | ||
| ?Determination of Intravascular Pressures | 21 | ||
| ?Doppler Measurements of Flow: Velocity-Time Integral (VTI) | 22 | ||
| ?Continuity Equation | 23 | ||
| ?Proximal Isovelocity Surface Area (PISA) | 24 | ||
| References | 25 | ||
| 5 - Principles and Physics: Transducer Characteristics | 26 | ||
| ?Transducers | 26 | ||
| ?Beamforming | 26 | ||
| References | 28 | ||
| 6 - Principles and Physics: Imaging Artifacts and Pitfalls | 29 | ||
| ?Reflection and Multipath | 29 | ||
| ?Refraction | 29 | ||
| ?Ringing, Rattling, and Reverberation | 29 | ||
| ?Attenuation | 29 | ||
| ?Reflective Shadowing | 29 | ||
| ?Near-Field Clutter | 30 | ||
| ?Side Lobes | 30 | ||
| ?Grating Lobes | 31 | ||
| ?Suboptimal Focusing and Lateral Resolution | 31 | ||
| ?Range Ambiguity | 31 | ||
| References | 32 | ||
| 7 - Normal Anatomy and Flow During the Complete Examination: Components of the Complete Examination | 33 | ||
| ?Introduction | 33 | ||
| ?Left Atrium, Pulmonary Veins, and Left Atrial Appendage | 33 | ||
| ?Left Ventricle | 33 | ||
| ?Mitral Valve | 36 | ||
| ?Aortic Valve | 38 | ||
| ?Right Atrium, Inferior Vena Cava, Superior Vena Cava, Interatrial Septum | 40 | ||
| ?Hepatic Veins | 41 | ||
| ?Right Ventricle | 42 | ||
| ?Tricuspid Valve | 42 | ||
| ?Pulmonic Valve | 43 | ||
| ?Aorta | 44 | ||
| References | 46 | ||
| 8 - Normal Anatomy and Flow During the Complete Examination: Epiaortic Imaging | 47 | ||
| ?Introduction | 47 | ||
| ?Indications | 47 | ||
| ?Stroke | 47 | ||
| ?Probes and Technique | 48 | ||
| ?Imaging Planes | 49 | ||
| ?Atherosclerotic Plaque Grading | 50 | ||
| ?Normal Dimensions | 50 | ||
| ?Doppler Interrogation of Ascending Aorta and Aortic Valve | 51 | ||
| ?Summary | 52 | ||
| References | 52 | ||
| 9 - Normal Anatomy and Flow During the Complete Examination: Three-Dimensional Views: Replicating the Surgeon's View | 54 | ||
| ?Transducer Design | 54 | ||
| ?Display of Three-Dimensional Images | 54 | ||
| ?Live 3D: Real-Time | 54 | ||
| ?3D Zoom: Real-Time | 56 | ||
| ?Full Volume: Gated | 56 | ||
| ?3D Color Doppler: Gated | 56 | ||
| ?Mitral Valve | 56 | ||
| ?Imaging the Aortic and Tricuspid Valves | 57 | ||
| ?Summary | 58 | ||
| References | 58 | ||
| 10 - Normal Anatomy and Flow During the Complete Examination: Extracardiac Anatomy | 59 | ||
| ?Introduction | 59 | ||
| ?Anatomic Relationships | 59 | ||
| ?Lungs and Pleural Spaces | 59 | ||
| ?Intraabdominal Fluid and Organs | 59 | ||
| ?Peritoneum | 59 | ||
| ?Liver | 63 | ||
| ?Inferior Vena Cava and Hepatic Veins | 67 | ||
| ?Stomach | 69 | ||
| ?Spleen | 69 | ||
| ?Kidney | 70 | ||
| ?Spinal Cord | 70 | ||
| ?Summary | 71 | ||
| References | 71 | ||
| 11 - Quantitative and Semiquantitative Echocardiography: Dimensions and Flows | 72 | ||
| ?Basic Principles | 72 | ||
| ?Measurement of Cardiac Chamber Dimensions | 72 | ||
| ?Measurement of Intracardiac Flows | 84 | ||
| ?Conclusions | 88 | ||
| References | 88 | ||
| 12 - Quantitative and Semiquantitative Echocardiography: Ventricular and Valvular Physiology | 90 | ||
| ?Introduction | 90 | ||
| ?Ventricular Function in Systole and Diastole | 90 | ||
| ?Measuring Stenosis | 101 | ||
| ?Measuring Regurgitation | 103 | ||
| ?Summary | 105 | ||
| References | 105 | ||
| Section II - Understanding How Transesophageal Echocardiography Demonstrates Cardiovascular Pathology | 107 | ||
| 13 - Myocardial Ischemia and Aortic Atherosclerosis | 108 | ||
| ?Coronary Anatomy and Myocardial Function | 108 | ||
| ?Myocardial Segments | 108 | ||
| ?Normal Segmental Function | 108 | ||
| ?Segmental Wall Motion Analysis | 108 | ||
| ?Wall Motion Score Index | 111 | ||
| ?Tissue Doppler Imaging | 111 | ||
| ?Color Tissue Doppler Imaging | 111 | ||
| ?Strain and Strain Rate | 111 | ||
| ?Speckle Tracking | 112 | ||
| ?Three-Dimensional TEE | 112 | ||
| ?Dobutamine Stress Echocardiography | 113 | ||
| ?Diastolic Function | 113 | ||
| ?Complications of Myocardial Ischemia and Associated Findings | 113 | ||
| ?Aortic Atherosclerosis | 117 | ||
| ?Conclusion | 122 | ||
| References | 124 | ||
| 14 - Aortic Valve Anatomy and Embryology | 125 | ||
| ?Transesophageal Echocardiographic Views for Aortic Valve Assessment | 125 | ||
| ?Aortic Stenosis | 126 | ||
| ?TEE for Transcatheter Aortic Valve Replacement | 131 | ||
| ?Aortic Regurgitation | 134 | ||
| ?TEE for Aortic Valve Repair | 137 | ||
| ?Echocardiographic Evaluation of Prosthetic Valves | 139 | ||
| References | 142 | ||
| 15 - Mitral Valvular Disease | 144 | ||
| ?Introduction | 144 | ||
| ?Functional Anatomy of the Mitral Valve | 144 | ||
| ?Mitral Valve Dysfunction and Etiology of Disease | 145 | ||
| ?Preprocedural Valve Analysis by TEE | 146 | ||
| ?Assessing Degree of Mitral Regurgitation | 149 | ||
| ?Mitral Valve Dysfunction and Reconstructive Valve Techniques | 149 | ||
| ?Postrepair Valve Analysis by TEE | 151 | ||
| ?Assessment of a Mitral Regurgitation Jet | 152 | ||
| ?Grading Mitral Stenosis | 153 | ||
| ?Future Directions | 155 | ||
| References | 155 | ||
| 16 - Tricuspid Valvular Disease | 156 | ||
| ?Overview | 156 | ||
| ?Functional Tricuspid Regurgitation | 156 | ||
| ?Functional Anatomy | 156 | ||
| ?Pathophysiology | 156 | ||
| ?Organic Tricuspid Disease | 157 | ||
| ?Indications for Tricuspid Valve Surgery | 157 | ||
| ?Rationale for Concomitant Tricuspid Repair | 157 | ||
| ?Surgical Considerations | 159 | ||
| References | 161 | ||
| 17 - Pulmonic Valvular Disease | 163 | ||
| ?Pulmonary Valve Stenosis | 163 | ||
| ?Transesophageal Echocardiography for Pulmonary Valve Assessment | 163 | ||
| ?Summary | 166 | ||
| References | 166 | ||
| 18 - Cardiomyopathies | 167 | ||
| ?Cardiomyopathy | 167 | ||
| ?Dilated Cardiomyopathy | 167 | ||
| ?Hypertrophic Cardiomyopathy | 171 | ||
| ?Restrictive Cardiomyopathy | 179 | ||
| ?Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia | 184 | ||
| ?Left Ventricular Noncompaction | 186 | ||
| ?Takotsubo Cardiomyopathy | 188 | ||
| ?Conclusion | 189 | ||
| References | 189 | ||
| 19 - Aneurysms and Dissections | 191 | ||
| ?Thoracic Aorta | 191 | ||
| ?Pulmonary Artery | 208 | ||
| ?Left Ventricle | 209 | ||
| ?Conclusions | 216 | ||
| References | 216 | ||
| 20 - Endocarditis | 218 | ||
| ?Duke Criteria | 218 | ||
| ?Transthoracic and Transesophageal Echocardiography | 218 | ||
| ?Complications of Infective Endocarditis | 220 | ||
| ?Prosthetic Valve Endocarditis | 221 | ||
| ?Intracardiac Device–Related Infections | 221 | ||
| ?Surgical Considerations | 221 | ||
| ?Surgery for Native Valve Endocarditis | 221 | ||
| ?Surgery for Prosthetic Valve Endocarditis | 222 | ||
| ?Summary | 222 | ||
| References | 222 | ||
| 21 - Imaging of Cardiac Tumors and Solid and Gaseous Materials | 224 | ||
| ?Introduction | 224 | ||
| ?Cardiac Pseudo-masses | 224 | ||
| ?Imaging True Cardiac Masses | 224 | ||
| ?Imaging Thrombi and Emboli | 229 | ||
| ?Imaging Intravascular Air | 232 | ||
| ?Summary | 237 | ||
| References | 238 | ||
| 22 - Intracardiac Devices, Catheters, and Cannulas | 241 | ||
| ?General Concepts | 241 | ||
| ?Cannulas | 241 | ||
| ?Intraaortic Balloon Pump | 244 | ||
| ?Ventricular Assist Devices | 245 | ||
| ?The Patient Receiving a Left Ventricular Assist Device | 246 | ||
| ?Right Ventricular Assist Devices | 251 | ||
| ?Pulmonary Artery Catheters | 251 | ||
| References | 252 | ||
| 23 - Echocardiographic Evaluation of Pericardial Disease | 253 | ||
| ?Pericardial Anatomy and Physiology | 253 | ||
| ?Pericardial Pathology | 256 | ||
| ?Constrictive Pericarditis | 260 | ||
| ?Pericardial Masses | 263 | ||
| References | 264 | ||
| 24 - Adult Congenital Heart Disease | 265 | ||
| ?Introduction | 265 | ||
| ?Indications for TEE | 265 | ||
| ?Impact of TEE | 265 | ||
| ?Anatomic Nomenclature: The Segmental Approach | 266 | ||
| ?Specific Congenital Cardiac Defects | 268 | ||
| ?Conclusions | 287 | ||
| References | 287 | ||
| 25 - Pulmonary Hypertension | 289 | ||
| ?Introduction | 289 | ||
| ?Pulmonary Hypertension and Right Heart Failure | 289 | ||
| ?Pathophysiology | 289 | ||
| ?Clinical Manifestations | 289 | ||
| ?Right Ventricle and Pathophysiology of Right Heart Failure | 289 | ||
| ?Echocardiographic Examination of the Pulmonary Hypertensive Patient | 290 | ||
| ?Conclusion | 295 | ||
| References | 296 | ||
| 26 - Recent Advances | 298 | ||
| ?Speckle Tracking Echocardiography | 298 | ||
| ?Cardiovascular Flow Visualization | 298 | ||
| References | 299 | ||
| Section III - Maintaining Quality of Perioperative Echocardiography | 301 | ||
| 27 - Indications for Transesophageal Echocardiography | 302 | ||
| ?Introduction | 302 | ||
| ?Who Gets TEE | 302 | ||
| ?Indications for Specific Procedures | 302 | ||
| ?TEE Outside the Cardiac Operating Room | 304 | ||
| ?New Technologies | 305 | ||
| ?Safety of TEE | 305 | ||
| ?Summary | 305 | ||
| References | 306 | ||
| 28 - Complications of Transesophageal Echocardiography | 307 | ||
| ?Introduction | 307 | ||
| ?Oropharyngeal Complications | 307 | ||
| ?Esophageal Perforation | 308 | ||
| ?Probe Mechanical Problems | 309 | ||
| ?Gastrointestinal Tract Bleeding | 309 | ||
| ?Other Injuries and Complications in Gastrointestinal Tract and Solid Organs | 309 | ||
| ?Respiratory Complications | 310 | ||
| ?Cardiovascular Effects | 311 | ||
| ?Probe Contamination | 311 | ||
| ?Infectious Complications | 311 | ||
| ?Local Anesthetic Complications | 312 | ||
| ?Contraindications | 312 | ||
| ?Summary | 312 | ||
| References | 312 | ||
| 29 - Equipment, Infection Control, and Safety | 314 | ||
| ?Introduction | 314 | ||
| ?Capital Equipment: Funding, Selection and Procurement | 314 | ||
| ?Evaluating Preventive Maintenance Programs and Product Support | 314 | ||
| ?Additional Considerations | 315 | ||
| ?Care of the TEE System | 315 | ||
| ?Infection Control Considerations | 316 | ||
| ?Manual Versus Automated Systems | 317 | ||
| ?Equipment Safety | 318 | ||
| ?Electrical Leakage Testing | 318 | ||
| ?Summary | 319 | ||
| References | 319 | ||
| Section IV - Oversight and Administration | 321 | ||
| 30 - Training and Certification for Transesophageal Echocardiography | 322 | ||
| ?Historical Perspective in the United States | 322 | ||
| ?Certification | 322 | ||
| ?Why Become Certified | 324 | ||
| ?Barriers to Certification | 324 | ||
| ?Future of Training/Certification | 324 | ||
| References | 325 | ||
| 31 - Medical Insurance Claims, Compliance, and Reimbursement for Anesthesiology | 326 | ||
| ?Introduction | 326 | ||
| ?Local Carrier Determinations and Medical Necessity | 326 | ||
| ?Provider Training and Credentialing | 326 | ||
| ?Compliant Documentation | 327 | ||
| ?Bundling of Reimbursements | 327 | ||
| ?Contracting for TEE Reimbursement | 328 | ||
| ?Monitoring TEE Services and Reimbursement | 328 | ||
| ?Conclusion | 328 | ||
| References | 328 | ||
| 32 - Regulatory, Legal, and Liability Issues Pertaining to Transesophageal Echocardiography | 329 | ||
| ?Introduction to the Interface of Law and Medicine | 329 | ||
| ?The FDA and Regulation of Medical Devices | 329 | ||
| ?Medical Device Defects and Medical Device Malfunctions | 330 | ||
| ?Importance of Practice Guidelines and Society Statements | 331 | ||
| ?Importance of State Laws | 332 | ||
| ?Policies and Procedures Impacting Hospital Practice | 332 | ||
| ?Informed Consent | 333 | ||
| ?Scope of Practice and the Anesthesia Care Team | 334 | ||
| ?Medical Malpractice | 334 | ||
| ?Medical Error and Disclosure | 335 | ||
| ?Documentation, Coding, and Billing for Services: False Claims Act Implications | 336 | ||
| ?HIPAA, Privacy, and Medical Information Security | 337 | ||
| ?Stark and Anti-kickback Statutes | 337 | ||
| ?Remote Monitoring and Telemedicine | 338 | ||
| ?Summary and Conclusions | 338 | ||
| References | 338 | ||
| INDEX | 341 | ||
| IBC | IBC |