Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Section I Basic sciences
- Section II Anaesthesia and peri-operative care for surgical specialties
- Section III At a glance
- Chapter 22 Scoring systems
- Chapter 23 Modes of mechanical ventilation
- Chapter 24 Fluids
- Chapter 25 Coagulation
- Chapter 26 Pre-operative echocardiography
- Chapter 27 Common drugs and doses
- Chapter 28 Physiology and risk in special circumstances
- Chapter 29 Medicolegal aspects of consent
- Chapter 30 Nerve injury
- Chapter 31 Pre-operative investigations
- Chapter 32 Enhanced recovery
- Chapter 33 Post-operative cognitive dysfunction
- List of abbreviations
- Index
Chapter 26 - Pre-operative echocardiography
Published online by Cambridge University Press: 05 July 2014
- Frontmatter
- Contents
- List of contributors
- Foreword
- Section I Basic sciences
- Section II Anaesthesia and peri-operative care for surgical specialties
- Section III At a glance
- Chapter 22 Scoring systems
- Chapter 23 Modes of mechanical ventilation
- Chapter 24 Fluids
- Chapter 25 Coagulation
- Chapter 26 Pre-operative echocardiography
- Chapter 27 Common drugs and doses
- Chapter 28 Physiology and risk in special circumstances
- Chapter 29 Medicolegal aspects of consent
- Chapter 30 Nerve injury
- Chapter 31 Pre-operative investigations
- Chapter 32 Enhanced recovery
- Chapter 33 Post-operative cognitive dysfunction
- List of abbreviations
- Index
Summary
Echocardiography is an important part of cardiovascular imaging and presents the events in motion as they occur in real life. It utilises sonographic principles, and can be non-invasive, i.e. trans thoracic echocardiography (TTE), or semi-invasive, i.e. transoesophageal echocardiography (TOE).
The technology of ultrasound has evolved over the last century and is now so advanced that in many ways the images are so clear that they are almost as good as direct observations of the heart.
TTE has become an invaluable tool for elucidating derangements in cardiac morphology and physiology. The results can allow surgery to proceed and guide best intra-operative care for high-risk patients. Appropriate post-operative care can be planned in advance and complications anticipated.
The indications for pre-operative TTE are surgery specific, and patient specific. Surgery specific indications for TTE are:
All patients undergoing cardiac surgery. Some operations (e.g. mitral valve surgery, endocarditis surgery) also require TOE
Operations where large blood loss or major intra-operative cardiovascular changes are expected (e.g. aortic surgery).
Patient-specific indications for pre-operative TTE are too many to discuss in detail. However, they can be grouped as follows:
Patients with undiagnosed or symptomatic heart murmurs
Patients with known heart murmurs but increasing symptoms
All patients with congenital heart disease must have a recent TTE or TOE (unless they have had cardiac MRI)
Advanced coronary artery disease listed for major elective surgery
All patients with symptoms of heart failure (breathlessness, high jugular venous pressure, extensive pedal oedema)
All patients with history of paradoxical embolism.
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- A Surgeon's Guide to Anaesthesia and Peri-operative Care , pp. 281 - 284Publisher: Cambridge University PressPrint publication year: 2014