Introductory Experience in Transesophageal Echocardiography for Anesthesiology Residents

Transesophageal echocardiography (TEE) has become an important imaging modality for anesthesiologists to monitor and identify major cardiothoracic pathology in both noncardiac and cardiac surgical patients during the perioperative period. Knowledge in basic TEE sonoanatomy and the ability to obtain 11 basic views is a necessary foundation for junior residents so they may focus on using TEE as a monitor and tool to identify major cardiothoracic pathology later in their training.

The purpose of the rotation is to introduce TEE image acquisition to clinical anesthesia Year 1 (CA-1) and CA-2 residents. In this module, the anesthesiology resident is assigned to a specific TEE-week rotation in the cardiovascular center. There are three main components to our TEE curriculum: (1) web-based and simulator-based exposure to image acquisition and sonoanatomy, (2) intraoperative exposure to image acquisition and sonoanatomy, and (3) the 11 standard basic TEE views worksheet and assessment tool.

Using the 11 standard basic TEE views assessment tool, 100% of the residents who went through the curriculum were able to obtain at least nine of the 11 views without prompting. Forty-five percent (n = 5) of CA-1 were able to obtain all 11 views without prompting, while 58% of the CA-2s were able to obtain all 11 views without prompting.

The preliminary results from our TEE curriculum are promising. We hope that this early exposure will lead to better learning on the residents' cardiac rotations in the CA-2 and CA-3 years by allowing them to start recognizing major pathology on TEE early on.