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The TEE-TWENTY Card
Compact reference card for the Twenty Views of the comprehensive Intraoperative TEE Exam - as jointly established by the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists.
The TEE-20 Card shows, on one side, the views which define this examination. The other side has the tables you need to quickly determine the severity of a valvular lesion, along with some essential hemodynamic formulae.
This is a perfect companion when studying for the Echo Exam, as this is all information that you need to know COLD ...
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Laminated TEE-20 Comprehensive IOE Exam Card
Click Here For Detail View Side One
Click Here For Detail View Side Two
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... The basic Comprehensive Intraoperative TEE Exam as defined by the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists is comprised of the twenty TEE views described by Shanewise (Shanewise et al., Anesthesia & Analgesia 1999; 89:870-884).
The front side of the TEE-TWENTY card shows all twenty of these sections with major structures labeled. In addition to the labels, a few of the sections, where important structures are located just outside of the sector scan, have had the graphic depiction extended beyond the sector boundaries – for example, the ME-AV-LAX view has been modified to show where the Right Pulmonary Artery lies just outside of the usual sector scan border.
Although the IOE truly is a ‘basic’ TEE examination sequence (for example, velocity profile determinations are not part of the exam) it is still quite complex and time consuming. Emergent and time-critical situations do not allow the leisure to attempt to obtain these twenty views. For this reason, we also offer the TEE Card, which is a concise tool for directing you to the most essential parts of a TEE exam in an unstable patient.
The reverse side of the TEE-TWENTY card consists of tables to help in the characterization of all common valvular stenotic and regurgitant abnormalities. The tables are based on current literature, and when significant disagreement between sources was found, a range is given.
The actually determination of a valvular lesion’s severity is dependent upon clinical state, cardiac loading conditions, the precise views obtained and echo machine settings. Still, these values are widely used to aid in the determination of a lesion’s severity, and certainly such values appear on written tests.
There is also a brief table of some of more commonly determined hemodynamic pressure estimations. A few more hemodynamic formulae can be found on our TEE Card. But, again, formulae are not the focus of that reference card either.
In sum the TEE-TWENTY card is a concise reference sheet to the comprehensive Intraoperative TEE Exam, and to the complexity of valvular lesions. It is of use in the operating room and in preparation for the echo exam.
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