Potential for Orogastric Tube Attached Transesophageal Echocardiography to Improve Intraoperative Image Quality

TEE image quality improvement with our devised probe cover

OBJECTIVE(S)

Our hypothesis was that our devised transesophageal echocardiography probe cover with the capacity for pinpoint suction would improve image quality.

DESIGN

Prospective cohort study.

SETTING

Single tertiary medical center.

PARTICIPANTS

Patients undergoing surgery requiring intraoperative transesophageal echocardiography.

INTERVENTIONS

Suctioning with inserted orogastric tube.

MEASUREMENTS AND MAIN RESULTS

Changes in image quality with suctioning were assessed by 2 methods. In method #1, investigators categorized the quality of all acquired images on a numeric scale based on each investigator's impression (1: very poor, 2: poor, 3: acceptable, 4: good, and 5: very good). In method #2, the reproducibility of the left ventricular fraction area change (LV FAC) was assessed, assuming that improved transgastric midpapillary short-axis view image quality would yield better LV FAC reproducibility. With method #1, for midesophageal views, 26.5%, 70.5%, and 3.0% of images showed improved, the same, and worsened image quality, respectively. For transgastric views, 55.3%, 43.3%, and 1.4% showed improved, the same, and worsened image quality, respectively. For deep transgastric views, 60.0%, 38.0%, and 2.0% showed improved, the same, and worsened image quality, respectively. With method #2, the presuction group had an ICC of 0.942 (95% CI: 0.91, 0.965). The postsuction group had an ICC of 0.988 (95% CI: 0.981, 0.993).

CONCLUSIONS

Our investigation validates the potential image quality improvement withour devised TEE probe cover. However, its clinical validity needs to be confirmed by further studies.