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Perioperative Two-Dimensional Transesophageal Echocardiography: A Practical Handbook.

Perioperative Two-Dimensional Transesophageal Echocardiography: A Practical Handbook. A. Vegas. Springer; Springer Science+Business Media, New York, USA; 44.95 [euro]; 127x203 mm; pp. 235; ISBN 978-1-4419-9951-1.

Perioperative Two-Dimensional Transesophageal Echocardiography is an excellent practical guide to cardiac surgically-relevant transoesophageal echocardiography in the operating room and the intensive care unit. At just 235 pages in a small soft cover, it would fit neatly into the pockets of surgical scrubs for use in and out of the operating room.

The highlights of the book are the over 450 figures, with wonderful schematic illustrations and accompanying two-dimensional and occasionally three-dimensional transoesophageal echocardiography images. Adjacent text explains fundamental concepts. Regular tables outline normal values and clinically relevant measurements for almost all cardiac calculations and pathology.

The book is logically set out with normal views, haemodynamics, then normal and pathological ventricular and valvular function. This is followed by excellent chapters on prosthetic valves, percutaneous cardiac procedures such as transcatheter valves and even an extensive chapter on congenital heart disease. Endocarditis and cardiac masses are addressed, as is cardiac transplantation, ventricular assist devices and pericardial disease. There is always an emphasis on clinically relevant imaging and pathology, including information on basic surgical approaches and what the surgeon needs to know. For such a small book it is amazingly comprehensive, reflecting the high-volume practice of all cardiac surgery at the authors' Toronto General Hospital.

The section on diastology is brief, almost an afterthought, but is in keeping with the practical nature of the book, given that intraoperative decision-making is rarely altered by diastolic parameters. Written by a cardiac anaesthetist and intended for an audience of cardiac anaesthetists and cardiac anaesthesia trainees, there is no discussion of noncardiac applications of transoesophageal echocardiography, nor on the use of perioperative transthoracic echocardiography. As such, it is unsuitable for use as a sole text for local University of Melbourne echocardiography courses, nor suitable for beginners looking to acquire basic transthoracic echocardiography knowledge.

No written text can truly do echocardiography justice, as learning is dependent on seeing dynamic moving images of cardiac structure and function. In addition, some element of hands-on learning is required to become skilled in probe manipulation and image acquisition.

Dr Vegas is also part of the group responsible for the terrific and free transoesophageal echo-cardiography website from the Toronto General Hospital ( This contains an interactive simulator with a three-dimensional heart, information on Doppler and some recent additions of pathology. This is perhaps the best free transoesophageal echocardiography website currently available. All clips play without incident on a dated windows platform and the site is suitable for novice echocardiographers.

The book is available for purchase on this website and is well-organised and good value for cardiac surgical related transoesophageal echocardiography applications.


Melbourne, Victoria
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Author:Cowie, B.S.
Publication:Anaesthesia and Intensive Care
Article Type:Book review
Date:Mar 1, 2012
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