Guidelines for Performing a Comprehensive Transesophageal Echocardiographic Examination: Recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists

Side, 1971, Non-surgical assessment of cardiac function, Nature, 232, 335, 10.1038/232335a0 Frazin, 1976, Esophageal echocardiography, Circulation, 54, 102, 10.1161/01.CIR.54.1.102 Hisanaga, 1980, High speed rotating scanner for transesophageal cross-sectional echocardiography, Am J Cardiol, 46, 837, 10.1016/0002-9149(80)90437-3 Hisanaga, 1977, A new transesophageal real-time two-dimensional echocardiographic system using a flexible tube and its clinical application, Proc Jpn Soc Ultrasonics Med, 32, 43 Shanewise, 1999, Anesth Analg, 89, 870, 10.1213/00000539-199910000-00010 Shanewise, 1999, J Am Soc Echocardiogr, 12, 884, 10.1016/S0894-7317(99)70199-9 Kallmeyer, 2001, The safety of intraoperative transesophageal echocardiography: a case series of 7200 cardiac surgical patients, Anesth Analg, 92, 1126, 10.1097/00000539-200105000-00009 Peterson, 2003, Transesophageal echocardiography: clinical indications and applications, Circulation, 107, 2398, 10.1161/01.CIR.0000071540.97144.89 Maffessanti, 2011, Quantitative analysis of mitral valve apparatus in mitral valve prolapse before and after annuloplasty: a three-dimensional intraoperative transesophageal study, J Am Soc Echocardiogr, 24, 405, 10.1016/j.echo.2011.01.012 Heidenreich, 1995, Transesophageal echocardiography predicts mortality in critically ill patients with unexplained hypotension, J Am Coll Cardiol, 26, 152, 10.1016/0735-1097(95)00129-N Meier, 2012, Secondary stroke prevention: patent foramen ovale, aortic plaque, and carotid stenosis, Eur Heart J, 33, 705, 10.1093/eurheartj/ehr443 Zamorano, 2011, EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease, J Am Soc Echocardiogr, 24, 937, 10.1016/j.echo.2011.07.003 Beller, 2008, ACCF 2008 recommendations for training in Adult Cardiovascular Medicine Core Cardiology Training (COCATS 3) (revision of the 2002 COCATS training statement), J Am Coll Cardiol, 51, 335, 10.1016/j.jacc.2007.11.008 Flachskampf, 2010, Recommendations for transoesophageal echocardiography: update 2010, Eur J Echocardiogr, 11, 557, 10.1093/ejechocard/jeq057 Cahalan, 2002, American Society of Echocardiography and Society of Cardiovascular Anesthesiologists task force guidelines for training in perioperative echocardiography, J Am Soc Echocardiogr, 15, 647, 10.1067/mje.2002.123956 Beique, 2006, Canadian guidelines for training in adult perioperative transesophageal echocardiography. Recommendations of the Cardiovascular Section of the Canadian Anesthesiologists’ Society and the Canadian Society of Echocardiography, Can J Cardiol, 22, 1015, 10.1016/S0828-282X(06)70317-8 Quinones, 2003, ACC/AHA clinical competence statement on echocardiography: a report of the American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine Task Force on clinical competence, J Am Soc Echocardiogr, 16, 379 Mathew, 2006, American Society of Echocardiography/Society of Cardiovascular Anesthesiologists recommendations and guidelines for continuous quality improvement in perioperative echocardiography, J Am Soc Echocardiogr, 19, 1303, 10.1016/j.echo.2006.08.039 Reeves, 2013, Basic perioperative transesophageal echocardiography examination: a consensus statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists, J Am Soc Echocardiogr, 26, 443, 10.1016/j.echo.2013.02.015 2010, Practice guidelines for perioperative transesophageal echocardiography. An updated report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography, Anesthesiology, 112, 1084 American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, 2011, J Am Soc Echocardiogr, 24, 229, 10.1016/j.echo.2010.12.008 American College of Cardiology Foundation Appropriate Use Criteria Task Force, 2013, Appropriate use of cardiovascular technology: 2013 ACCF appropriate use criteria methodology update, J Am Coll Cardiol, 61, 1305, 10.1016/j.jacc.2013.01.025 Intersocietal Accrediation Commission. IAC standards for adult echocardiography accreditation. Available at: http://www.intersocietal.org/echo/standards/IACAdultEchocardiographyStandards2012.pdf. Accessed July 27, 2013. Daniel, 1991, Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations, Circulation, 83, 817, 10.1161/01.CIR.83.3.817 Khandheria, 1994, Transesophageal echocardiography, Mayo Clin Proc, 69, 856, 10.1016/S0025-6196(12)61788-1 Hilberath, 2010, Safety of transesophageal echocardiography, J Am Soc Echocardiogr, 23, 1115, 10.1016/j.echo.2010.08.013 Seward, 1992, Critical appraisal of transesophageal echocardiography: limitations, pitfalls, and complications, J Am Soc Echocardiogr, 5, 288, 10.1016/S0894-7317(14)80352-0 Lennon, 2005, Transesophageal echocardiography-related gastrointestinal complications in cardiac surgical patients, J Cardiothorac Vasc Anesth, 19, 141, 10.1053/j.jvca.2005.01.020 Owall, 1992, Incidence of sore throat and patient complaints after intraoperative transesophageal echocardiography during cardiac surgery, J Cardiothorac Vasc Anesth, 6, 15, 10.1016/1053-0770(91)90037-T Chan, 1991, Complications of transesophageal echocardiography in ambulatory adult patients: analysis of 1500 consecutive examinations, J Am Soc Echocardiogr, 4, 577, 10.1016/S0894-7317(14)80216-2 1996, 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, 84, 986, 10.1097/00000542-199604000-00029 Picard, 2011, American Society of Echocardiography recommendations for quality echocardiography laboratory operations, J Am Soc Echocardiogr, 24, 1, 10.1016/j.echo.2010.11.006 2002, Practice guidelines for sedation and analgesia by non-anesthesiologists, Anesthesiology, 96, 1004, 10.1097/00000542-200204000-00031 2011, Anesthesiology, 114, 495, 10.1097/ALN.0b013e3181fcbfd9 Winter, 1954, Persistent left superior vena cava; survey of world literature and report of thirty additional cases, Angiology, 5, 90, 10.1177/000331975400500207 Fraser, 1961, Left superior vena cava: a review of associated congenital heart lesions, catheterization data and roentgenologic findings, Am J Med, 31, 711, 10.1016/0002-9343(61)90155-3 Aldrete, 1998, Modifications to the postanesthesia score for use in ambulatory surgery, J Perianesth Nurs, 13, 148, 10.1016/S1089-9472(98)80044-0 Isenberg, 2001, Topical anesthesia: to use or not to use—that is the question, Gastrointest Endosc, 53, 130, 10.1067/mge.2001.112093 Soma, 2001, Evaluation of topical pharyngeal anesthesia for upper endoscopy including factors associated with patient tolerance, Gastrointest Endosc, 53, 14, 10.1067/mge.2001.111773 Hedenbro, 1992, A randomized, double-blind, placebo-controlled study to evaluate topical anaesthesia of the pharynx in upper gastrointestinal endoscopy, Endoscopy, 24, 585, 10.1055/s-2007-1010550 Froehlich, 1995, Conscious sedation for gastroscopy: patient tolerance and cardiorespiratory parameters, Gastroenterology, 108, 697, 10.1016/0016-5085(95)90441-7 Smith, 1985, Controlled comparison of topical anesthetic agents in flexible upper gastrointestinal endoscopy, Gastrointest Endosc, 31, 255, 10.1016/S0016-5107(85)72175-X Kane, 2007, Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from 28 478 transesophageal echocardiograms: incidence, outcomes, and predisposing factors, Arch Intern Med, 167, 1977, 10.1001/archinte.167.18.1977 Novaro, 2003, Benzocaine-induced methemoglobinemia: experience from a high-volume transesophageal echocardiography laboratory, J Am Soc Echocardiogr, 16, 170, 10.1067/mje.2003.5 Coleman, 1996, Drug-induced methaemoglobinaemia. Treatment issues, Drug Saf, 14, 394, 10.2165/00002018-199614060-00005 Qadeer, 2005, Propofol versus traditional sedative agents for gastrointestinal endoscopy: a meta-analysis, Clin Gastroenterol Hepatol, 3, 1049, 10.1016/S1542-3565(05)00742-1 Carpentier, 1995, The “physio-ring”: an advanced concept in mitral valve annuloplasty, Ann Thorac Surg, 60, 1177, 10.1016/0003-4975(95)00753-8 Foster, 1998, Accurate localization of mitral regurgitant defects using multiplane transesophageal echocardiography, Ann Thorac Surg, 65, 1025, 10.1016/S0003-4975(98)00084-8 Lang, 2012, EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography, J Am Soc Echocardiogr, 25, 3, 10.1016/j.echo.2011.11.010 Stewart, 1992, Evaluation of mitral leaflet motion by echocardiography and jet direction by Doppler color flow mapping to determine the mechanisms of mitral regurgitation, J Am Coll Cardiol, 20, 1353, 10.1016/0735-1097(92)90248-L Chandra, 2011, Characterization of degenerative mitral valve disease using morphologic analysis of real-time three-dimensional echocardiographic images: objective insight into complexity and planning of mitral valve repair, Circ Cardiovasc Imaging, 4, 24, 10.1161/CIRCIMAGING.109.924332 Tsang, 2011, The value of three-dimensional echocardiography derived mitral valve parametric maps and the role of experience in the diagnosis of pathology, J Am Soc Echocardiogr, 24, 860, 10.1016/j.echo.2011.05.015 Omran, 2002, Intraoperative transesophageal echocardiography accurately predicts mitral valve anatomy and suitability for repair, J Am Soc Echocardiogr, 15, 950, 10.1067/mje.2002.121534 David, 2005, A comparison of outcomes of mitral valve repair for degenerative disease with posterior, anterior, and bileaflet prolapse, J Thorac Cardiovasc Surg, 130, 1242, 10.1016/j.jtcvs.2005.06.046 Otsuji, 2001, Mechanism of ischemic mitral regurgitation with segmental left ventricular dysfunction: three-dimensional echocardiographic studies in models of acute and chronic progressive regurgitation, J Am Coll Cardiol, 37, 641, 10.1016/S0735-1097(00)01134-7 Lang, 2012, 3D echocardiographic quantification in functional mitral regurgitation, JACC Cardiovasc Imaging, 5, 346, 10.1016/j.jcmg.2012.02.005 Cosgrove, 1989, Mitral valvuloplasty, Curr Probl Cardiol, 14, 359, 10.1016/S0146-2806(89)80002-7 Ho, 2002, Anatomy of the mitral valve, Heart, 88, iv5 Muresian, 2009, The clinical anatomy of the mitral valve, Clin Anat, 22, 85, 10.1002/ca.20692 McCarthy, 2010, Anatomy of the mitral valve: understanding the mitral valve complex in mitral regurgitation, Eur J Echocardiogr, 11, i3, 10.1093/ejechocard/jeq153 Quinones, 2002, Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography, J Am Soc Echocardiogr, 15, 167, 10.1067/mje.2002.120202 Lewis, 1984, Pulsed Doppler echocardiographic determination of stroke volume and cardiac output: clinical validation of two new methods using the apical window, Circulation, 70, 425, 10.1161/01.CIR.70.3.425 Ormiston, 1981, Size and motion of the mitral valve annulus in man. I. A two-dimensional echocardiographic method and findings in normal subjects, Circulation, 64, 113, 10.1161/01.CIR.64.1.113 Foster, 2009, Accurate measurement of mitral annular dimensions by echocardiography: importance of correctly aligned imaging planes and anatomic landmarks, J Am Soc Echocardiogr, 22, 458, 10.1016/j.echo.2009.02.008 Sadik, 2005, Improved stroke volume assessment in the aortic and mitral valves with a new method in subjects without regurgitation, Eur J Echocardiogr, 6, 210, 10.1016/j.euje.2004.09.012 Hyodo, 2012, Accurate measurement of mitral annular area by using single and biplane linear measurements: comparison of conventional methods with the three-dimensional planimetric method, Eur Heart J Cardiovasc Imaging, 13, 605, 10.1093/ejechocard/jer300 Legget, 1998, Three-dimensional measurement of the mitral annulus by multiplane transesophageal echocardiography: in vitro validation and in vivo demonstration, J Am Soc Echocardiogr, 11, 188, 10.1016/S0894-7317(98)70076-8 Grewal, 2010, Mitral annular dynamics in myxomatous valve disease: new insights with real-time 3-dimensional echocardiography, Circulation, 121, 1423, 10.1161/CIRCULATIONAHA.109.901181 Zoghbi, 2003, Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography, J Am Soc Echocardiogr, 16, 777, 10.1016/S0894-7317(03)00335-3 Baumgartner, 2009, Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice, J Am Soc Echocardiogr, 22, 1, 10.1016/j.echo.2008.11.029 Thavendiranathan, 2012, Quantitative assessment of mitral regurgitation: validation of new methods, J Am Coll Cardiol, 60, 1470, 10.1016/j.jacc.2012.05.048 Thavendiranathan P, Liu S, Datta S, Rajagopalan S, Ryan T, Igo SR, et al. Quantification of chronic functional mitral regurgitation by automated 3-D peak and integrated proximal isovelocity surface area and stroke volume techniques using real-time 3-D volume color Doppler echocardiography: in vitro and clinical validation. Circ Cardiovasc Imaging 2013;6:125-33. Messika-Zeitoun, 2010, Multimodal assessment of the aortic annulus diameter: implications for transcatheter aortic valve implantation, J Am Coll Cardiol, 55, 186, 10.1016/j.jacc.2009.06.063 Anderson, 2000, Clinical anatomy of the aortic root, Heart, 84, 670, 10.1136/heart.84.6.670 Piazza, 2008, Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve, Circ Cardiovasc Interv, 1, 74, 10.1161/CIRCINTERVENTIONS.108.780858 Leye, 2009, Size-adjusted left ventricular outflow tract diameter reference values: a safeguard for the evaluation of the severity of aortic stenosis, J Am Soc Echocardiogr, 22, 445, 10.1016/j.echo.2009.02.007 Shiran, 2009, Accuracy and reproducibility of left ventricular outflow tract diameter measurement using transthoracic when compared with transesophageal echocardiography in systole and diastole, Eur J Echocardiogr, 10, 319, 10.1093/ejechocard/jen254 Zoghbi, 2009, J Am Soc Echocardiogr, 22, 975, 10.1016/j.echo.2009.07.013 Lang, 2005, J Am Soc Echocardiogr, 18, 1440, 10.1016/j.echo.2005.10.005 Lopez, 2010, Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council, J Am Soc Echocardiogr, 23, 465, 10.1016/j.echo.2010.03.019 Hiratzka, 2010, J Am Coll Cardiol, 55, e27, 10.1016/j.jacc.2010.02.015 Roman, 1989, Two-dimensional echocardiographic aortic root dimensions in normal children and adults, Am J Cardiol, 64, 507, 10.1016/0002-9149(89)90430-X Bloomfield, 2012, A practical guide to multimodality imaging of transcatheter aortic valve replacement, JACC Cardiovasc Imaging, 5, 441, 10.1016/j.jcmg.2011.12.013 Konstadt, 1994, The ascending aorta: how much does transesophageal echocardiography see?, Anesth Analg, 78, 240, 10.1213/00000539-199402000-00008 Otani, 2010, Assessment of the aortic root using real-time 3D transesophageal echocardiography, Circ J, 74, 2649, 10.1253/circj.CJ-10-0540 Saitoh, 2012, Comparison of left ventricular outflow geometry and aortic valve area in patients with aortic stenosis by 2-dimensional versus 3-dimensional echocardiography, Am J Cardiol, 109, 1626, 10.1016/j.amjcard.2012.01.391 Doddamani, 2007, Demonstration of left ventricular outflow tract eccentricity by real time 3D echocardiography: implications for the determination of aortic valve area, Echocardiography, 24, 860, 10.1111/j.1540-8175.2007.00479.x Shahgaldi, 2010, Direct measurement of left ventricular outflow tract area using three-dimensional echocardiography in biplane mode improves accuracy of stroke volume assessment, Echocardiography, 27, 1078, 10.1111/j.1540-8175.2010.01197.x Zamorano, 2011, EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease, Eur Heart J, 32, 2189, 10.1093/eurheartj/ehr259 Santos, 2012, Prosthesis/annulus discongruence assessed by three-dimensional transoesophageal echocardiography: a predictor of significant paravalvular aortic regurgitation after transcatheter aortic valve implantation, Eur Heart J Cardiovasc Imaging, 13, 931, 10.1093/ehjci/jes072 Janosi, 2011, Measurement of the aortic annulus size by real-time three-dimensional transesophageal echocardiography, Minim Invasive Ther Allied Technol, 20, 85, 10.3109/13645706.2011.557385 Tsang, 2012, Accuracy of aortic annular measurements obtained from three-dimensional echocardiography, CT and MRI: human in vitro and in vivo studies, Heart, 98, 1146, 10.1136/heartjnl-2012-302074 Gripari, 2012, Intraoperative 2D and 3D transoesophageal echocardiographic predictors of aortic regurgitation after transcatheter aortic valve implantation, Heart, 98, 1229, 10.1136/heartjnl-2012-301998 Kasel, 2013, Standardized imaging for aortic annular sizing: implications for transcatheter valve selection, JACC Cardiovasc Imaging, 6, 249, 10.1016/j.jcmg.2012.12.005 Martinez, 2005, Echocardiographic features of the morphologically right ventriculo-arterial junction, Cardiol Young, 15, 17, 10.1017/S1047951105000983 Kurup, 2007, Infundibular pulmonary stenosis, Anesth Analg, 104, 507, 10.1213/01.ane.0000255204.39328.0b Prabhu, 2009, Trans-esophageal echocardiography for tricuspid and pulmonary valves, Ann Card Anaesth, 12, 167, 10.4103/0971-9784.53439 Stoddard, 1992, Comparison of cardiac dimensions by transesophageal and transthoracic echocardiography, Am Heart J, 124, 675, 10.1016/0002-8703(92)90277-3 Antunes, 2007, Management of tricuspid valve regurgitation, Heart, 93, 271, 10.1136/hrt.2006.095281 Rogers, 2009, The tricuspid valve: current perspective and evolving management of tricuspid regurgitation, Circulation, 119, 2718, 10.1161/CIRCULATIONAHA.108.842773 Shah, 2008, Tricuspid valve disease, Curr Probl Cardiol, 33, 47, 10.1016/j.cpcardiol.2007.10.004 Nath, 2004, Impact of tricuspid regurgitation on long-term survival, J Am Coll Cardiol, 43, 405, 10.1016/j.jacc.2003.09.036 Voelkel, 2006, Right ventricular function and failure: report of a National Heart, Lung, and Blood Institute Working Group on Cellular and Molecular Mechanisms of Right Heart Failure, Circulation, 114, 1883, 10.1161/CIRCULATIONAHA.106.632208 Bustamante-Labarta, 2002, Right atrial size and tricuspid regurgitation severity predict mortality or transplantation in primary pulmonary hypertension, J Am Soc Echocardiogr, 15, 1160, 10.1067/mje.2002.123962 Hung, 1998, Usefulness of echocardiographic determined tricuspid regurgitation in predicting event-free survival in severe heart failure secondary to idiopathic-dilated cardiomyopathy or to ischemic cardiomyopathy, Am J Cardiol, 82, 1301, 10.1016/S0002-9149(98)00624-9 Tang, 2006, Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes, Circulation, 114, I577 Dreyfus, 2005, Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair?, Ann Thorac Surg, 79, 127, 10.1016/j.athoracsur.2004.06.057 Martinez, 2006, Anatomy and echocardiography of the normal and abnormal tricuspid valve, Cardiol Young, 16, 4, 10.1017/S1047951106000709 Kostucki, 1986, Pulsed Doppler regurgitant flow patterns of normal valves, Am J Cardiol, 58, 309, 10.1016/0002-9149(86)90068-8 Anwar, 2007, Assessment of normal tricuspid valve anatomy in adults by real-time three-dimensional echocardiography, Int J Cardiovasc Imaging, 23, 717, 10.1007/s10554-007-9210-3 Fukuda, 2006, Three-dimensional geometry of the tricuspid annulus in healthy subjects and in patients with functional tricuspid regurgitation: a real-time, 3-dimensional echocardiographic study, Circulation, 114, I492 Skiles, 2000, Transesophageal echocardiographic (TEE) evaluation of ventricular function, Cardiol Clin, 18, 681, 10.1016/S0733-8651(05)70174-0 Roelandt, 1992, Multiplane transesophageal echocardiography: latest evolution in an imaging revolution, J Am Soc Echocardiogr, 5, 361, 10.1016/S0894-7317(14)80268-X Ho, 2009, Anatomy and myoarchitecture of the left ventricular wall in normal and in disease, Eur J Echocardiogr, 10, iii3, 10.1093/ejechocard/jen243 Hozumi, 1993, Quantitation of left ventricular volumes and ejection fraction by biplane transesophageal echocardiography, Am J Cardiol, 72, 356, 10.1016/0002-9149(93)90688-9 Colombo, 2002, Cross-sectional multiplane transesophageal echocardiographic measurements: comparison with standard transthoracic values obtained in the same setting, Echocardiography, 19, 383, 10.1046/j.1540-8175.2002.00383.x Lappas, 1999, Prevalence of left ventricular diastolic filling abnormalities in adult cardiac surgical patients: an intraoperative echocardiographic study, Semin Thorac Cardiovasc Surg, 11, 125, 10.1016/S1043-0679(99)70005-5 Denault, 2006, Left and right ventricular diastolic dysfunction as predictors of difficult separation from cardiopulmonary bypass, Can J Anaesth, 53, 1020, 10.1007/BF03022532 Swaminathan, 2011, Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery, Ann Thorac Surg, 91, 1844, 10.1016/j.athoracsur.2011.02.008 Rudski, 2010, J Am Soc Echocardiogr, 23, 685, 10.1016/j.echo.2010.05.010 Blackshear, 1996, Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation, Ann Thorac Surg, 61, 755, 10.1016/0003-4975(95)00887-X Manning, 1995, Accuracy of transesophageal echocardiography for identifying left atrial thrombi. A prospective, intraoperative study, Ann Intern Med, 123, 817, 10.7326/0003-4819-123-11-199512010-00001 Donal, 2005, The left atrial appendage, a small, blind-ended structure: a review of its echocardiographic evaluation and its clinical role, Chest, 128, 1853, 10.1378/chest.128.3.1853 Halperin, 2003, Obliteration of the left atrial appendage for prevention of thromboembolism, J Am Coll Cardiol, 42, 1259, 10.1016/S0735-1097(03)00958-6 Damiano, 2003, The long-term outcome of patients with coronary disease and atrial fibrillation undergoing the Cox maze procedure, J Thorac Cardiovasc Surg, 126, 2016, 10.1016/j.jtcvs.2003.07.006 Healey, 2005, Left Atrial Appendage Occlusion Study (LAAOS): results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke, Am Heart J, 150, 288, 10.1016/j.ahj.2004.09.054 Holmes, 2009, Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial, Lancet, 374, 534, 10.1016/S0140-6736(09)61343-X Nakai, 2002, Percutaneous left atrial appendage occlusion (PLAATO) for preventing cardioembolism: first experience in canine model, Circulation, 105, 2217, 10.1161/01.CIR.0000015605.30810.51 Sievert, 2002, Percutaneous left atrial appendage transcatheter occlusion to prevent stroke in high-risk patients with atrial fibrillation: early clinical experience, Circulation, 105, 1887, 10.1161/01.CIR.0000015698.54752.6D Qamruddin, 2010, Left atrial appendage: structure, function, imaging modalities and therapeutic options, Expert Rev Cardiovasc Ther, 8, 65, 10.1586/erc.09.161 Su, 2008, Occluding the left atrial appendage: anatomical considerations, Heart, 94, 1166, 10.1136/hrt.2006.111989 1994, Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials, Arch Intern Med, 154, 1449, 10.1001/archinte.1994.00420130036007 Nucifora, 2011, Evaluation of the left atrial appendage with real-time 3-dimensional transesophageal echocardiography: implications for catheter-based left atrial appendage closure, Circ Cardiovasc Imaging, 4, 514, 10.1161/CIRCIMAGING.111.963892 Veinot, 1997, Anatomy of the normal left atrial appendage: a quantitative study of age-related changes in 500 autopsy hearts: implications for echocardiographic examination, Circulation, 96, 3112, 10.1161/01.CIR.96.9.3112 Ho, 2011, Anatomy of the left atrium for interventional echocardiography, Eur J Echocardiogr, 12, i11, 10.1093/ejechocard/jer093 Block, 2002, Comparison of left atrial dimensions by transesophageal and transthoracic echocardiography, J Am Soc Echocardiogr, 15, 143, 10.1067/mje.2002.121399 Castello, 1990, Spontaneous echocardiographic contrast in the descending aorta, Am Heart J, 120, 915, 10.1016/0002-8703(90)90210-O Lelorier, 2004, Prognostic differences between atrial fibrillation and atrial flutter, Am J Cardiol, 93, 647, 10.1016/j.amjcard.2003.11.042 The SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators, 1998, Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III Study, JAMA, 279, 1273, 10.1001/jama.279.16.1273 Sigurdsson, 2007, Detection of pulmonary vein stenosis by transesophageal echocardiography: comparison with multidetector computed tomography, Am Heart J, 153, 800, 10.1016/j.ahj.2007.01.039 Samdarshi, 1991, Assessment of pulmonary vein stenosis by transesophageal echocardiography, Am Heart J, 122, 1495, 10.1016/0002-8703(91)90605-H Nakajima, 2010, Analysis of the left atrial appendage by three-dimensional transesophageal echocardiography, Am J Cardiol, 106, 885, 10.1016/j.amjcard.2010.05.014 Latcu, 2009, Real-time three-dimensional transoesophageal echocardiography for diagnosis of left atrial appendage thrombus, Eur J Echocardiogr, 10, 711, 10.1093/ejechocard/jep076 Shah, 2008, Real-time three-dimensional transesophageal echocardiography of the left atrial appendage: initial experience in the clinical setting, J Am Soc Echocardiogr, 21, 1362, 10.1016/j.echo.2008.09.024 Hagen, 1984, Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts, Mayo Clin Proc, 59, 17, 10.1016/S0025-6196(12)60336-X Schneider, 1990, Improved morphologic characterization of atrial septal aneurysm by transesophageal echocardiography: relation to cerebrovascular events, J Am Coll Cardiol, 16, 1000, 10.1016/S0735-1097(10)80354-7 Pearson, 1991, Atrial septal aneurysm and stroke: a transesophageal echocardiographic study, J Am Coll Cardiol, 18, 1223, 10.1016/0735-1097(91)90539-L Gallet, 1985, Atrial septal aneurysm—a potential cause of systemic embolism. An echocardiographic study, Br Heart J, 53, 292, 10.1136/hrt.53.3.292 Belkin, 1987, Atrial septal aneurysm: association with cerebrovascular and peripheral embolic events, Stroke, 18, 856, 10.1161/01.STR.18.5.856 Mugge, 1995, Atrial septal aneurysm in adult patients. A multicenter study using transthoracic and transesophageal echocardiography, Circulation, 91, 2785, 10.1161/01.CIR.91.11.2785 Hanley, 1985, Diagnosis and classification of atrial septal aneurysm by two-dimensional echocardiography: report of 80 consecutive cases, J Am Coll Cardiol, 6, 1370, 10.1016/S0735-1097(85)80228-X Loukas, 2010, Chiari’s network: review of the literature, Surg Radiol Anat, 32, 895, 10.1007/s00276-010-0639-z Schneider, 1995, Chiari’s network: normal anatomic variant or risk factor for arterial embolic events?, J Am Coll Cardiol, 26, 203, 10.1016/0735-1097(95)00144-O Hausmann, 1995, Identification of patent foramen ovale permitting paradoxic embolism, J Am Coll Cardiol, 26, 1030, 10.1016/0735-1097(95)00288-9 Faletra, 2010, Anatomy of right atrial structures by real-time 3D transesophageal echocardiography, JACC Cardiovasc Imaging, 3, 966, 10.1016/j.jcmg.2010.03.014 Marriott, 2013, Detection of right-to-left atrial communication using agitated saline contrast imaging: experience with 1162 patients and recommendations for echocardiography, J Am Soc Echocardiogr, 26, 96, 10.1016/j.echo.2012.09.007 Soliman, 2007, The use of contrast echocardiography for the detection of cardiac shunts, Eur J Echocardiogr, 8, S2, 10.1016/j.euje.2007.03.006 Belvis, 2006, Almost perfect concordance between simultaneous transcranial Doppler and transesophageal echocardiography in the quantification of right-to-left shunts, J Neuroimaging, 16, 133, 10.1111/j.1552-6569.2006.00021.x Mas, 2001, Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both, N Engl J Med, 345, 1740, 10.1056/NEJMoa011503 Homma, 2002, PFO in Cryptogenic Stroke Study (PICSS) Investigators. Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study, Circulation, 105, 2625, 10.1161/01.CIR.0000017498.88393.44 Holmes, 2009, Patent foramen ovale, systemic embolization, and closure, Curr Probl Cardiol, 34, 483, 10.1016/j.cpcardiol.2009.06.001 Baker, 2009, Usefulness of live three-dimensional transesophageal echocardiography in a congenital heart disease center, Am J Cardiol, 103, 1025, 10.1016/j.amjcard.2008.11.060 Sreeram, 1990, Comparative value of transthoracic and transesophageal echocardiography in the assessment of congenital abnormalities of the atrioventricular junction, J Am Coll Cardiol, 16, 1205, 10.1016/0735-1097(90)90554-3 Hausmann, 1992, Value of transesophageal color Doppler echocardiography for detection of different types of atrial septal defect in adults, J Am Soc Echocardiogr, 5, 481, 10.1016/S0894-7317(14)80039-4 Feltes, 1994, Transesophageal echocardiographic detection of atrial thrombi in patients with nonfibrillation atrial tachyarrhythmias and congenital heart disease, J Am Coll Cardiol, 24, 1365, 10.1016/0735-1097(94)90121-X Fyfe, 1991, Transesophageal echocardiography detects thrombus formation not identified by transthoracic echocardiography after the Fontan operation, J Am Coll Cardiol, 18, 1733, 10.1016/0735-1097(91)90512-8 Hirsch, 1994, St John Sutton MG, Somerville J. Diagnosis in adolescents and adults with congenital heart disease. Prospective assessment of individual and combined roles of magnetic resonance imaging and transesophageal echocardiography, Circulation, 90, 2937, 10.1161/01.CIR.90.6.2937 Ayres, 2005, Indications and guidelines for performance of transesophageal echocardiography in the patient with pediatric acquired or congenital heart disease: report from the task force of the Pediatric Council of the American Society of Echocardiography, J Am Soc Echocardiogr, 18, 91, 10.1016/j.echo.2004.11.004 Stevenson, 1993, Transesophageal echocardiography during repair of congenital cardiac defects: identification of residual problems necessitating reoperation, J Am Soc Echocardiogr, 6, 356, 10.1016/S0894-7317(14)80234-4 Stevenson, 2003, Utilization of intraoperative transesophageal echocardiography during repair of congenital cardiac defects: a survey of North American centers, Clin Cardiol, 26, 132, 10.1002/clc.4960260307 Hoppe, 1996, Congenital heart disease in adults and adolescents: comparative value of transthoracic and transesophageal echocardiography and MR imaging, Radiology, 199, 669, 10.1148/radiology.199.3.8637985 Mullen, 2003, Intracardiac echocardiography guided device closure of atrial septal defects, J Am Coll Cardiol, 41, 285, 10.1016/S0735-1097(02)02616-5