Intra-operative transoesophageal echocardiography

Medical Services Advisory Committee
Record ID 32002000521
Authors' objectives:

This report provides a systematic review of literature on intraoperative transoesophageal echocardiography (TOE), a procedure used to obtain high quality, ultrasonic images of the heart and associated structures during surgery.

Authors' recommendations: Based on clinical evidence and current best practice, it can be concluded that: i) Intra-operative TOE during valve and congenital surgery is considered standard care and is becoming routine for cardiac surgery in general. Its role in noncardiac surgery is uncertain. ii) Intra-operative TOE is able to detect changes in cardiac function with high specificity. iii) Intra-operative TOE results in frequent changes in intra-operative management of patients with cardiac valve and congenital heart disease and other high-risk cases such as aortic dissection. iv) Intra-operative TOE is reported to be safe. v) There is no evidence to date that intra-operative TOE results in better patient outcomes. vi) Evidence suggests that intra-operative TOE is often associated with adjustment to clinical management. vii) There may be cost savings associated with the use of intra-operative TOE through a reduction in the number of repeated operations since the results of intra-operative TOE evaluation allow immediate surgical changes to be made. MSAC has found that there is limited evidence of the safety, effectiveness and cost-effectiveness of intraoperative transoesophageal echocardiography. MSAC recommends that public funding for this procedure should be supported on an interim basis and restricted to intra-operative assessment of cardiac valve competence following valve replacement or repair. The provision of funding should be reconsidered no later than June 2005 to ascertain whether further additional evidence has become available which supports continued funding.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2002
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Australia
MeSH Terms
  • Costs and Cost Analysis
  • Echocardiography, Transesophageal
  • Heart Diseases
Organisation Name: Medical Services Advisory Committee
Contact Address: MSAC (MDP 107), GPO Box 9848, Canberra, ACT 2601, Australia. Tel: +61 2 6289 6811; Fax: +61 2 6289 8799.
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Copyright: Medical Services Advisory Committee (MSAC)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.