naa a22 4500 510727689 CHVBK 20180411082941.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s11748-013-0208-6 doi (NATIONALLICENCE)springer-10.1007/s11748-013-0208-6 Intraoperative cardiac assessment with transesophageal echocardiography for decision-making in cardiac anesthesia [Elektronische Daten] [Koichi Akiyama, Shoji Arisawa, Masahiro Ide, Masaaki Iwaya, Yoshiyuki Naito] Transesophageal echocardiography is an invaluable hemodynamic monitoring modality. Extended and anatomically based evaluation of cardiac function with transesophageal echocardiography is essential to prompt and accurate decision-making in anesthetic management during cardiac surgery. Fractional shortening and fractional area changes are indices widely used to assess the global systolic performance of the left ventricle. Monitoring regional function using semi-quantitative scoring has been demonstrated to be a more sensitive indicator of myocardial ischemia. Assessment of left ventricular diastolic function should be performed in a systematic way, measuring transmitral flow, pulmonary venous flow, transmitral color M-mode flow propagation velocity, and mitral annulus tissue Doppler imaging. The unique anatomical features of the right ventricle make echocardiographic evaluation complicated and therefore less frequently employed. Right ventricular fractional area change, tricuspid annular plane systolic excursion, maximal systolic tricuspid annular velocity with tissue Doppler imaging, and myocardial performance index are indices successfully incorporated into intraoperative right ventricular assessment. Left ventricular outflow tract obstruction with systolic anterior motion of the mitral valve may develop after cardiac procedures. Transesophageal echocardiography plays a central role in prevention as well as diagnosis of systolic anterior motion. Transesophageal echocardiography is extremely useful not only for detecting and locating intracardiac air, but also for guiding and evaluating the procedures to remove air. Air is likely to persist in the right and left superior pulmonary vein, left ventricular apex, left atrium, right coronary sinus of Valsalva, and ascending aorta. Accurate evaluation of cardiac function depends on performing TEE examination properly and obtaining optimal images. The Japanese Association for Thoracic Surgery, 2013 Transesophageal echocardiography nationallicence Systolic function nationallicence Diastolic function nationallicence Systolic anterior motion nationallicence Intracardiac air nationallicence Akiyama Koichi Department of Anesthesia, Akashi Medical Center, 743-33 Okubo-cho Yagi, 674-0063, Akashi, Japan aut Arisawa Shoji Anesthesia Associates of Kobe, 5-8-16-502 Nagate-cho, Nada-ku, 657-0027, Kobe, Japan aut Ide Masahiro Anesthesia Associates of Kobe, 5-8-16-502 Nagate-cho, Nada-ku, 657-0027, Kobe, Japan aut Iwaya Masaaki Anesthesia Associates of Kobe, 5-8-16-502 Nagate-cho, Nada-ku, 657-0027, Kobe, Japan aut Naito Yoshiyuki Department of Anesthesia, Akashi Medical Center, 743-33 Okubo-cho Yagi, 674-0063, Akashi, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/6(2013-06-01), 320-329 1863-6705 61:6<320 2013 61 11748 https://doi.org/10.1007/s11748-013-0208-6 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-013-0208-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Akiyama Koichi Department of Anesthesia, Akashi Medical Center, 743-33 Okubo-cho Yagi, 674-0063, Akashi, Japan aut NATIONALLICENCE 700 1- Arisawa Shoji Anesthesia Associates of Kobe, 5-8-16-502 Nagate-cho, Nada-ku, 657-0027, Kobe, Japan aut NATIONALLICENCE 700 1- Ide Masahiro Anesthesia Associates of Kobe, 5-8-16-502 Nagate-cho, Nada-ku, 657-0027, Kobe, Japan aut NATIONALLICENCE 700 1- Iwaya Masaaki Anesthesia Associates of Kobe, 5-8-16-502 Nagate-cho, Nada-ku, 657-0027, Kobe, Japan aut NATIONALLICENCE 700 1- Naito Yoshiyuki Department of Anesthesia, Akashi Medical Center, 743-33 Okubo-cho Yagi, 674-0063, Akashi, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/6(2013-06-01), 320-329 1863-6705 61:6<320 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer