oa Southern African Journal of Anaesthesia and Analgesia - Change or be changed; anaesthetist accreditation in echocardiography : is it time? : guest editorial
Anaesthesiologists worldwide have embraced the emerging technology of transoesophageal echocardiography (TEE) since its introduction to clinical practice almost twenty years ago. Cardiac anaesthetists who were there at its inception were given a fantastic tool, which literally switched on the floodlights and allowed proper visualisation of a game which had up to that point been played in relative darkness. The mysteries of weaning from bypass were solved in an instant and ventricular performance, volume loading, papillary muscle dysfunction and, that condition that had plagued cardiac anaesthetists everywhere, the left ventricular outflow tract obstruction in aortic stenosis and chronic hypertension, became clear and more easily managed during the weaning process. With time and experience, anaesthetists developed skills that they had never thought would be possible, such as the comprehensive assessment of the heart before and after bypass, assessment of left ventricular wall motion abnormalities and, that potential mine field, assessment of valvular structure and, particularly, function after repair.
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