Transesophageal echocardiography interpretation: A comparative analysis between cardiac anesthesiologists and primary echocardiographers

Joseph P. Mathew*, Manuel L. Fontes, Susan Garwood, Elizabeth Davis, William D. White, Gerard McCloskey, Jane C K Fitch, Sherif Afifi, David L. Lee, Phillip Kraker, Terence D. Rafferty, Paul G. Barash, Linda Gillam, Edward Prokop

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Diagnostic interpretation of intraoperative transesophageal echocardiography (TEE) examinations may vary, particularly when the echocardiographer is also the anesthesiologist. We therefore evaluated the concordance of TEE interpretation as part of a process of continuous quality improvement (CQI). Ten cardiac anesthesiologists participating in a CQI program conducted 154 comprehensive TEE examinations, each consisting of 16 major fields describing cardiac anatomy and function. These examinations were subsequently interpreted offline by two primary echocardiographers (a radiologist and a cardiologist). Agreement was assessed using the K coefficient and percent agreement. Overall K and percent agreement were 0.58 and 83% for anesthesiologists versus radiologist, 0.57 and 80% for anesthesiologists versus cardiologist, and 0.60 and 82% for radiologist versus cardiologist. Anesthesiologists with longer than 5 yr of TEE experience had higher levels of agreement with the radiologist when assessing the aorta, right atrium, pulmonary vein flow, transmitral flow, and fractional area change. Cardiac anesthesiologists supported by a CQI program interpret TEE examinations at a level comparable with physicians whose primary practice is echocardiography. Thus, the anesthesiologist and the intraoperative echocardiographer need not be mutually exclusive.

Original languageEnglish (US)
Pages (from-to)302-309
Number of pages8
JournalAnesthesia and analgesia
Issue number2
StatePublished - 2002

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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