Loyola University Medical Center, Maywood, Illinois, USA.
Curr Opin Anaesthesiol. 2010 Feb;23(1):80-8. doi: 10.1097/ACO.0b013e328334a6b3.
The use of two-dimensional (2D) transesophageal echocardiography (TEE) is nearly universal in cardiac surgical operating rooms around the world. Cardiac anesthesiologists or cardiologists perform these examinations, facilitating significant advancements in surgical techniques by the immediacy and accuracy of intra-operative ultrasound imaging. Three-dimensional (3D) TEE capabilities have been available since the 1990s but penetration has been poor. With the advent of real-time 3D TEE, interest in this technology has increased dramatically. This is a comprehensive review of English language publications in the field from 2007 to 2009.
This review utilized Pubmed databases, with search strategy based on primary key words: 3D echocardiography, transesophageal echocardiography, cardiac surgery, and/or cardiopulmonary bypass. Three major areas of clinical practice are impacted by the findings of these studies: cardiac valve repair and replacement, assessment of ventricular function, and image guidance for percutaneous procedures.
The review resulted in the conclusion that 3D TEE provides unique and dynamic 3D spatial information that cannot be obtained by 2D TEE or fluoroscopy. In addition to technical and process advancements, future studies should address educational value in terms of acceleration of learning curves, and impact on surgical decision making.
二维(2D)经食管超声心动图(TEE)在全球范围内的心脏外科手术室中几乎普遍使用。心脏麻醉师或心脏病专家进行这些检查,通过术中超声成像的即时性和准确性,促进了手术技术的重大进步。三维(3D)TEE 功能自 20 世纪 90 年代以来就已经存在,但普及率一直很低。随着实时 3D TEE 的出现,人们对这项技术的兴趣大大增加。这是对 2007 年至 2009 年该领域英文出版物的全面综述。
本综述利用了 Pubmed 数据库,其搜索策略基于主要关键词:3D 超声心动图、经食管超声心动图、心脏手术和/或体外循环。这些研究结果对三个主要的临床实践领域产生了影响:心脏瓣膜修复和置换、心室功能评估以及经皮介入程序的图像引导。
该综述得出的结论是,3D TEE 提供了 2D TEE 或荧光透视无法获得的独特和动态的 3D 空间信息。除了技术和流程方面的进步外,未来的研究还应探讨教育价值,包括加速学习曲线以及对手术决策的影响。