ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stanton K. Shernan
Tomislav Mihaljevic
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rosenberger, P.
Right arrow Articles by Eltzschig, H. K.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Rosenberger, P.
Right arrow Articles by Eltzschig, H. K.
Related Collections
Right arrowRelated Article

Ann Thorac Surg 2005;79:1092-1093
© 2005 The Society of Thoracic Surgeons

Correspondence

Transesophageal Echocardiography for Pulmonary Embolectomy

Peter Rosenberger, MD, Stanton K. Shernan, MD

Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115

Tomislav Mihaljevic, MD

Division of Cardiac Surgery, Harvard Medical School

Holger K. Eltzschig, MD

Department of Anesthesiology and Intensive Care Medicine, Tübingen University Hospital, Tübingen D-72076, Germany

(E-mail: heltzschig{at}partners.org).

To the Editor:

We read with great interest the excellent case report by Georghiou and coworkers [1] that describes a patient who underwent pulmonary embolectomy for massive pulmonary embolus. This patient's outcome corroborates the recently described favorable experience in patients from our institution undergoing surgical pulmonary embolectomy [2]. However, we were surprised that use of intraoperative transesophageal echocardiography (TEE) was not mentioned in the management of this patient. The American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists highly recommend TEE during pulmonary embolectomy [3, 4]. As a relatively safe and noninvasive diagnostic modality, TEE does not interfere with ongoing resuscitation efforts [5, 6] and can facilitate cannula placement and identification of thrombotic material within the pulmonary artery [7]. Moreover, TEE can identify intrathoracic thromboembolism in the inferior or superior vena cava, the right atrium, or the right heart [8]. We recently demonstrated in a series of 50 consecutive patients undergoing pulmonary embolectomy that TEE reveals extrapulmonary thromboemboli within the previously described locations in as many as 26% of all patients [9]. If not surgically removed, such extrapulmonary thromboemboli can become the source of recurrent pulmonary embolism. Therefore we believe that intraoperative TEE should be considered in patients undergoing pulmonary embolectomy, even in the presence of acute hemodynamic instability.


   References
Top
 References
 

  1. Georghiou GP, Brauner R, Berman M, et al. Successful resuscitation of a patient with acute massive pulmonary embolism using emergent embolectomy Ann Thorac Surg 2004;77:697-699.[Abstract/Free Full Text]
  2. Aklog L, Williams CS, Byrne JG, Goldhaber SZ. Acute pulmonary embolectomy: a contemporary approach Circulation 2002;105:1416-1419.[Abstract/Free Full Text]
  3. Practice guidelines for perioperative transesophageal echocardiography. A report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Anesthesiology 1996;84:986–1006..
  4. Cahalan MK, Abel M, Goldman M, et al. American Society of Echocardiography and Society of Cardiovascular Anesthesiologists task force guidelines for training in perioperative echocardiography Anesth Analg 2002;94:1384-1388.[Free Full Text]
  5. van der Wouw PA, Koster RW, Delemarre BJ, et al. Diagnostic accuracy of transesophageal echocardiography during cardiopulmonary resuscitation J Am Coll Cardiol 1997;30:780-783.[Abstract]
  6. Redberg RF, Tucker K, Schiller NB. Transesophageal echocardiography during cardiopulmonary resuscitation Cardiol Clin 1993;11:529-535.[Medline]
  7. Rosenberger P, Shernan SK, Body SC, Eltzschig HK. Utility of intraoperative transesophageal echocardiography for diagnosis of pulmonary embolism. Anesth Analg 2004;99:12–6..
  8. Funakoshi Y, Kato M, Kuratani T, et al. Successful treatment of massive pulmonary embolism in the 38th week of pregnancy Ann Thorac Surg 2004;77:694-695.[Abstract/Free Full Text]
  9. Rosenberger P, Shernan SK, Mihaljevic T, Eltzschig HK. Transesophageal echocardiography for detecting extrapulmonary thrombi during pulmonary embolectomy. Ann Thorac Surg 2004;78:862–6..

Related Article

Transesophageal Echocardiography for Pulmonary Embolectomy: Reply
Georgios P. Georghiou, Eldad Erez, Bernardo A. Vidne, and Alex Sagie
Ann. Thorac. Surg. 2005 79: 1093. [Extract] [Full Text] [PDF]




This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stanton K. Shernan
Tomislav Mihaljevic
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rosenberger, P.
Right arrow Articles by Eltzschig, H. K.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Rosenberger, P.
Right arrow Articles by Eltzschig, H. K.
Related Collections
Right arrowRelated Article

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS