Table 1 Intraoperative TEE Approach to Intracardiac IPDE and PE
Intraoperative TEE assessment | Key points of TEE focus |
|---|---|
Basic views ME 4C/ ME LAX/ ME RVIOT/ TG Mid SAX | Is the foramen ovale patent? Are there thrombi in both atria? Is there flattening and paradoxical motion of the ventricular septum? Are there regurgitations in the tricuspid and pulmonary valves? Is there right ventricular dilation and abnormal motion? Is there impaired left ventricular diastolic function and low cardiac output? |
Goal-directed views Modified 4C/RVIOT/UE AA SAX/ ME Asc Aortic SAX/ TG RV basal | Confirm the status of thrombi in the foramen ovale; presence of McConnell’s sign? Is there a suspicious thrombus in the right ventricular outflow tract, obstruction, or is the Doppler spectrum of the right ventricular outflow tract indicative of pulmonary hypertension? Presence of the 60/60 sign? Are there visible thrombi in the pulmonary arteries? |
Post cardiopulmonary bypass (including above views) | Cardiac function, are preoperative abnormalities (such as pericardial/thoracic effusion, valvular regurgitation, intracardiac shunt, thrombi, valvular) repaired? |