Fifteen Years of Transesophageal Echocardiography in Cardiac Anesthesia in Russia.

Transesophageal echocardiography was first introduced in Russia as a component of anesthesiology monitoring in 2003 following its successful implementation in the practice of cardiac anesthesia in the United States and Western Europe. This novel opportunity for perioperative hemodynamic evaluation was enthusiastically adopted at several cardiac surgical clinics despite the presence of critical barriers. The most important of these were the lack of certification programs for anesthesiologists, limited equipment, and a lack of understanding of the responsibility of the anesthesiologist as the coordinator of perioperative therapeutic decisions. Although intraoperative transesophageal echocardiography as a part of the anesthesiology protocol has been introduced in less than 10% of Russian cardiac surgery clinics, a group of interested anesthesiologists has formed over the last 15 years. Both the technical conditions and professional mentality of anesthesiologists need to be changed substantially for successful further development of intraoperative echocardiography. This review aims to highlight the milestones, successes, and challenges in the implementation of intraoperative echocardiography in the practice of cardiac anesthesiology in Russia, which may be interesting to a wide range of cardiac anesthesiologists.

Produção Científica Sobre Ecocardiografia Transesofágica por Países Ibero-Americanos / Scientific Output on Transesophageal Echocardiography from Iberoamerican Countries

Fundamento: A ecocardiografia transesofágica (ETE) tem atraído grande atenção e está se tornando um campo científico importante e rapidamente crescente. Objetivo: Analisar a contribuição e as características das publicações científicas sobre ETE na Ibero-América. Métodos: Uma pesquisa bibliográfica foi realizada no PubMed (US National Library of Medicine National Institutes of Health) para identificar publicações científicas sobre ETE indexadas até 1º de maio de 2015. Os termos utilizados na pesquisa bibliográfica incluíram "ecocardiografia transesofágica", "ecocardiograma transesofágico", ecocardiografia transesofágica 3D" e "ecocardiografia tridimensional". Esses termos foram vinculados a cada país ibero-americano. Dados adicionais sobre as revistas de cada publicação científica foram obtidos a partir do SCImago Journal & Country Rank. Resultados: A Ibero-América originou 4% de todas as publicações sobre ETE. O número de publicações da Ibero-América aumentou de zero antes de 1990 a 60 em 2015. A Espanha, o México e o Brasil originaram 75% de todas as publicações da região. Cerca de 30% dos textos completos eram de acesso livre. A maioria das publicações científicas era em inglês. Cerca de 90% das publicações eram relatos de casos ou séries de casos sobre endocardite infecciosa, tumores ou massas cardíacas, doença cardíaca congênita, fontes cardioembólicas de acidente vascular cerebral e cardiologia intervencionista invasiva. A Espanha e a Argentina foram os países que originaram manuscritos com maior probabilidade de serem publicados em revistas estrangeiras. Cerca de 40% das publicações ibero-americanas foram em revistas classificadas no quartil superior das revistas científicas em seu respectivo campo. Conclusões: A produção científica sobre ETE na Ibero-América é limitada, mas vem aumentando. O número e as características das publicações sobre ETE mostram diferenças notáveis entre os países ibero-americanos. (Int J Cardiovasc Sci. 2016;29(6):422-430)

Transesophageal echocardiography (TEE) has attracted great attention and is becoming an important, rapid­progressing scientific field. Objective: To analyse the contribution and characteristics of scientific publications on TEE from Iberoamerica. Methods: A literature search was conducted in PubMed (US National Library of Medicine National Institutes of Health) to identify scientific publications on TEE indexed before May 1, 2015. Terms used for the literature search included "transesophageal echocardiography", "transesophageal echocardiogram", "3D transesophageal echocardiography", and "three­dimensional echocardiography". These terms were combined with each Iberoamerican country. Additional data from the journal of each scientific publication were obtained from the SCImago Journal & Country Rank. Results: Iberoamerica originated 4% of all publications on TEE. The number of publications from Iberoamerica increased from zero before 1990 to 60 in 2015. Spain, Mexico, and Brazil originated 75% of all publications from the region. About 30% of full­texts were freely available. Most of the scientific publications were in English. About 90% of the publications were case reports or case series about infectious endocarditis, tumors or cardiac masses, congenital heart disease, cardioembolic sources of stroke, and invasive interventional cardiology. Spain and Argentina were the countries that originated manuscripts with a higher likelihood of being published in foreign journals. About 40% of Iberoamerican publications were in journals ranked in the top 25% of scientific journals in their field. Conclusions: The scientific production on TEE from Iberoamerica is limited, but is increasing. The number and characteristics of publications on TEE show notable differences between Iberoamerican countries.

The Remarkable 50 Years of Imaging in HCM and How it Has Changed Diagnosis and Management: From M-Mode Echocardiography to CMR.

The almost 50-year odyssey of cardiac imaging in hypertrophic cardiomyopathy (HCM), revisited and described here, has been remarkable, particularly when viewed in the timeline of advances that occurred during a single generation of investigators. At each step along the way, from M-mode to 2-dimensional echocardiography to Doppler imaging, and finally over the last 10 years with the emergence of high-resolution tomographic cardiac magnetic resonance (CMR), evolution of the images generated by each new technology constituted a paradigm change over what was previously available. Together, these advances have transformed the noninvasive diagnosis and management of HCM in a number of important clinical respects. These changes include a more complete definition of the phenotype, resulting in more reliable clinical identification of patients and family members, defining mechanisms (and magnitude) of left ventricular outflow obstruction, and novel myocardial tissue characterization (including in vivo detection of fibrosis/scarring); notably, these advances afford more precise recognition of at-risk patients who are potential candidates for life-saving primary prevention defibrillator therapy. This evolution in imaging as applied to HCM has indelibly changed cardiovascular practice for this morphologically and clinically complex genetic disease.

Perioperative transoesophageal echocardiography: current status and future directions.

Transoesophageal echocardiography (TOE) is used in the perioperative arena to monitor patients during life-threatening emergencies, cardiac and high-risk non-cardiac surgeries. It provides qualitative and quantitative information on valvular and ventricular functions, and dynamic cardiac anatomy can be displayed with a physiological perspective. This technology has evolved from two-dimensional (2D) to the ready availability of real-time three-dimensional (RT-3D) imaging in the operating rooms. Enhanced spatial and temporal resolutions with 3D imaging have most significantly impacted the quality of intraoperative surgical valve repair and replacement decisions. Additionally, 3D imaging has facilitated the advent of minimally invasive and percutaneous interventions for structural heart disease. Information derived from TEE is routinely used to evaluate a patient's suitability for an intervention, provide guidance during the intervention and eventually comment on the quality and success of the procedure. Expertise in perioperative TEE is an integral component of a cardiac anaesthesiologist's skill sets. With structural heart disease interventions becoming more minimally invasive, the intraoperative guidance provided by TEE will continue to be a critical component of these procedures. With improving computational and processing power, the expectations from TEE will continue to be incremental in the perioperative arena.

An essay on 35 years of the Society of Cardiovascular Anesthesiologists.

This is an historical account of the accomplishments of the Society of Cardiovascular Anesthesiologists from its founding in 1989 to the present. It is written on the occasion of the 35th anniversary of the founding of this organization. The society accomplishments include providing a means to educate anesthesiologists and others about the perioperative care of patients undergoing cardiac, thoracic, and vascular surgery. The society has led accreditation of transesophageal echocardiography and education in cardiothoracic anesthesia. The society publishes a section within Anesthesia & Analgesia and supports investigation by providing a forum for the discussion of research and funding peer-reviewed projects. The first 35 years of the Society of Cardiovascular Anesthesiologists has been remarkable in all that has been accomplished.

The evolution of intraoperative transesophageal echocardiography.

In this article, the development of intraoperative transesophageal echocardiography (TEE) is reviewed. It took two decades to develop the present clinical applications of TEE. This modality will continue to serve as a monitor and diagnostic tool to ensure better care of patients in the operating room and the intensive care units.

Two decades of transesophageal phased array probes.

After its introduction about two decades ago, transesophageal echocardiography (TEE) has rapidly evolved into an important diagnostic feature for the cardiologist, since it offers anatomic and hemodynamic information which cannot be obtained precordially. Part of this success was due to the developments in transducer technology which resulted in smaller probes with progressively better imaging qualities. A short review of past, recent and future developments of TEE phased array probes, in particular those at the Erasmus University in Rotterdam, will be given. Furthermore, this article discusses basic parameters of the transducer dictating image quality such as centre frequency, array aperture and focusing illustrated with several simulations. The simulations show that a poor design of the transducer will limit the resolution and will give artefacts in the two-dimensional image.