News | Cardiovascular Ultrasound | June 04, 2020

New Guideline Outlines Use of Transesophageal Echo to Assist Surgical Decision-making

New ASE document explains role of intra-operative TEE

A Philips Healthcare transesophageal echocardiography (TEE) system in use in a hybrid OR.

A Philips Healthcare transesophageal echocardiography (TEE) system in use in a hybrid OR.

June 4, 2020 — Intra-operative transesophageal echocardiography (TEE) is a versatile diagnostic and monitoring tool used to assist in patient management in a wide-range of cardiac surgical procedures. The new American Society of Echocardiography (ASE) document, "Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach," outlines a systematic approach on how to apply the existing guidelines to address questions on cardiac structure and function specific to the intra-operative environment in open, minimally invasive, or hybrid procedures. 

This peer-reviewed guideline was developed in collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons (STS) and has also been endorsed by 18 ASE International Alliance Partners.

“The intraoperative echocardiographer should be an integral and active part of the heart team," explained chair of the ASE guideline writing group, Alina Nicoara, M.D., FASE, associate professor of anesthesiology, Duke University Medical Center. "Utilizing a ‘catch-all’ protocol as a starting point for imaging in all procedures and all patients enables standardization of image acquisition, reduction in variability in quality of imaging and reporting, and ultimately, better patient care. Clear communication of the echocardiographic findings to the surgical team, as well as understanding the impact of new findings on the surgical plan, are paramount. Equally important is the need for an informed understanding of the technical steps of the surgical procedures being performed and the complications that may occur, in order to direct the post procedure evaluation toward aspects directly related to the surgical procedure and to provide pertinent echocardiographic information.”

In conjunction with the publication of this guideline, Nicoara and writing group co-chair Nikolaos Skubas, M.D., FASE, will conduct a live webinar, including a question and answer section, on July 9, 2020, at 5 p.m. Eastern time. The webinar will be available for free to all ASE members and open to all other clinicians for $25. Registration will open soon and access to all ASE-hosted guideline webinars is available on the ASE Learning Hub.

The full guideline document is available on the Journal of American Society of Echocardiography (JASE) website.  This document and all ASE guideline documents are also available to the medical community at

Find more ASE news



1. Alina Nicoara, Nikolaos Skubas, Niv Ad, et al. Guidelines for the Use of Transesophageal Echocardiography to Assist with SurgicalDecision-Making in the Operating Room: A Surgery-Based Approach. American Society of Echocardiography. 




Related Content

New echo technology and products at the 2018 ASE meeting.
Feature | ASE | June 22, 2018
More than 60 companies and organizations are displaying their latest products and services at the 2018 American Socie
GE Healthcare Vivid T8 cardiac ultrasound, highlights from the American Society of Echo ASE 2017
Feature | ASE | June 26, 2017
June 26, 2017 — Here is a list of some key clinical presentations and video interviews with cardiac ultrasound though
Videos | ASE | June 30, 2016
DAIC/ITN editor Dave Fornell shares some of the innovative new technologies on the show floor of the American Society