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Transesophageal echocardiographic evaluation in mechanically assisted circulation
Summary
Transesophageal echocardiography (TEE) aids in selecting mechanical circulatory support devices and optimizing their performance. This imaging technique is valuable for managing patients with assist devices and assessing ventricular recovery during weaning.
Area of Science:
- Cardiothoracic Surgery
- Cardiovascular Imaging
- Mechanical Circulatory Support
Background:
- Transesophageal echocardiography (TEE) is increasingly vital in cardiothoracic surgery.
- Its utility in patients with mechanically assisted circulation remains incompletely defined.
Purpose of the Study:
- To evaluate the role of TEE in patients with various mechanical assist devices (AD).
- To assess TEE's effectiveness in AD selection, patient management, and device optimization.
Main Methods:
- TEE was performed in 11 patients with different types of mechanical circulatory support.
- Patients included those with total artificial heart (TAH), right ventricular assist device (RVAD), left ventricular assist device (LVAD), and biventricular assist device (BVAD).
Main Results:
- TEE facilitated AD selection by assessing biventricular function and identifying failure types.
- It confirmed correct cannula placement and pump flow, identifying right ventricular failure as a cause of instability in 4 LVAD patients.
- TEE guided optimal pump settings in a patient with RVAD and hypotension, and assessed ventricular recovery during weaning.
Conclusions:
- TEE is a valuable tool in mechanically assisted circulation for AD selection and patient management.
- It aids in optimizing pump performance and monitoring ventricular function during weaning from assist devices.