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Neil David Hauser and Justiaan Swanevelder

Trans-oesophageal echocardiography (TOE) has become an almost universal intraoperative monitor and diagnostic tool. The use of TOE in most cardiac, aortic, major vascular and transplant operations is used to aid anaesthetic management as well as assist surgical decision-making. In addition to the perioperative environment it is increasingly being used in the Outpatient Department, Emergency Department and Intensive Care settings. In this review we consider the safety associated with the use of TOE, we review the suggested contra-indications and areas that we would consider to TOE to be a necessity. Two case reports at the beginning of the review highlight the need for vigilance and care when utilizing TOE.

Open access

Neil David Hauser and Justiaan Swanevelder

Transoesophageal echocardiography (TOE) has, in certain clinical situations, become an almost universal monitor and diagnostic tool. In the perioperative environment, TOE is frequently used to guide anaesthetic management and assist with surgical decision making for, but not limited to, cardiothoracic, major vascular and transplant operations. The use of TOE is not limited to the theatre environment being frequently used in outpatient clinics, emergency departments and intensive care settings. Two case reports, one of oesophageal perforation and another of TOE utilization in a patient having previously undergone an oesophagectomy, introduce the need for care while using TOE and highlight the need for vigilance. The safe use of TOE, the potential complications and the suggested contra-indications are then considered together with suggestions for improving the safety of TOE in adult and paediatric patients.