8^th Global Cardiologists and Echocardiography Annual Meeting

Biography

Biography: Baris Cankaya

Abstract

Transesophageal echocardiography has a wide use in perioperative period. Heart chambers, valves, vessels, fluid management are all in view of TEE. But, limitations are appearing with experience progressing. A novel limitation is invisibility of the aortic arch. Undiagnosed atherosclerosis originating from ascending aorta is a major problem causing neurologic complications during cardiac surgery. Visualizing thoracic aorta is also important for transaortic heart valve implantation. TEE's lacking sensitivity for atherosclerosis in distal aortic arch is corrected with a view TEE. This technic is based on overcoming the air in trachea. Usage of A view TEE before sternotomy gives an advantage against epiaortic ultrasound. TEE allows continious monitoring and does not interfere with surgical site. This allows a complete visualization of distal aortic arch, thoracic aorta and origins of the cerebral arteries. Epiaortic ultrasound has the advantage of a high frequency probe on it for further analyzing the atherom plaque. Isala safety check and Katz classification helped for perioperative management, and mortality has reduced significantly. Preoxygenation and experience are important because of the time limitation. This procedure will help surgical team to review treatment plan. Adjustments of cannulation, distal arch cannulation, and intermittent ventricular fibrillating method and off pump surgery are the changes according to visualization. Further experience with a view TEE will help more for neurologic outcome in near future.