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Canadian Journal of Anesthesia 47:192 (2000)
© Canadian Anesthesiologists' Society, 2000

Correspondence

Transthoracic echocardiography pre-, intra-, and postoperatively

Miodrag Filipovic, MD, Manfred D. Seeberger , MD, Luzius Steiner and Karl Skarvan, MD

Basel, Switzerland

To the Editor:

We fully agree with Hadiç and co-authors concerning the use of transthoracic echocardiography (TTE) in the perioperative period.1 In addition to its use pre- and postoperatively, we use TTE as an intraoperative noninvasive hemodynamic monitor in patients with severe cardiac disease undergoing surgical procedures in regional anesthesia. Thus, our indications for perioperative use of TTE include: 1) preoperative TTE to evaluate unclear cardiac status, e.g. clinical suspicions of aortic stenosis, in patients needing urgent surgery but no immediately available cardiologist-echocardiographer, 2) intraoperative TTE to monitor patients with severe cardiac disease undergoing surgery in regional anesthesia, and 3) postoperative TTE in patients with severe hemodynamic instability occurring after extubation. The use of TTE by anesthesiologists prevents unnecessary delays of surgery, allows extended noninvasive hemodynamic monitoring during regional anesthesia, and facilitates postoperative patient care. To obtain appropriate information from TTE, anesthesiologists-echocardiographers performing TTE need formal training in the transthoracic echocardiographic approach.

Reference

1 Hadiç A, Vloka JD, Koorn R, Thys DM. Transthoracic echocardiography in perioperative medicine (Letter). Can J Anesth 1999; 46: 616.[Free Full Text]





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