Comprehensive Textbook of Perioperative Transesophageal Echocardiography, 2nd ed

There has been an incredible proliferation of echocardiography books over the past decade. A quick search on Amazon.com reveals >1000 in-stock titles. Even when potential buyers limit the focus to transesophageal echocardiography (TEE), they are still left with several hundred choices under the “medical” heading. Although many books fulfill specialty niches, in general most are either paperbacks, which provide a quick review of the subject, or hardcover books designed to serve as “in-depth” references. As its title implies, this latest work by Drs. Savage, Aronson, and Shernan falls clearly into the latter category, and admirably accomplishes the task of being an authoritative text. Similar to the first edition of this text, this book covers all the basic through the most advanced concepts in TEE, making it useful for both expert users and those striving to become experts. The book's 39 chapters are divided into 3 major headings: basic perioperative echocardiography, echocardiography in the critical care setting, and advanced applications in perioperative echocardiography. The new organizational structure represents a vast improvement over the original text. Complementary chapters are now grouped together and easily identifiable. For example, “Assessment in Aortic Valve Surgery” is now immediately followed by “Surgical Considerations and Assessment in Aortic Surgery.” Providing both the echocardiographic and surgical aspects of specific pathologies is one of the textbook's strengths, particularly for those working in the operating room. It should be noted that the second edition's title has been slightly changed from intraoperative TEE to perioperative TEE. This reflects the new edition's increased number of chapters devoted to echocardiography outside of the operating room, including the intensive care unit, echo lab, and interventional suites. In addition to TEE, other echo modalities, such as transthoracic, epiaortic, epicardial, and vascular access ultrasound, are also covered. A brand new chapter devoted to strain and 3-dimensional echocardiography represents an important addition to the original text. Most of the strengths of the first edition have been maintained. This is especially true of the full-color figures, which include concise diagrams, well-labeled echo images, and beautiful medical illustrations. Combined with clear writing from experts in the field, the chapters do an excellent job of presenting the material in an effective manner. A certain number of redundancies and minor discrepancies can be expected in any multi-author, large-volume text, and these have been kept to a minimum by the editors. The chapters are all well referenced, with most citing several dozen papers from the peer-reviewed medical literature. Similar to the first edition, each chapter ends with a “Key Points” box and a few multiple-choice questions to highlight the important aspects of each topic. A new feature of this edition is the inclusion of access to a full web-based version of the book (www.textbookoftee.com), which provides a certain degree of “portability” by being able to read it from just about any Internet-connected computer. Search tools are readily available to easily gather relevant paragraphs and figures on the topic of interest. An online test, similar to the end-of-chapter questions, is also available. A major shortcoming of the electronic version of the book is that the images are merely electronic versions of the published still frames and do not provide additional value beyond those available in the paper version of the book. Given that echocardiography is a motion-based imaging modality, it would have been helpful to have included video clips within the electronic version of the book. This is particularly disappointing because the editors of the book all have expertise in this area and affiliations with other echocardiography websites. Despite the drawback of relying on still images, the second edition of this book remains an excellent educational resource. It is one of the few, perhaps only, comprehensive echocardiography texts written by experts in the operating room setting for readers working in the operative setting. Both novice practitioners (e.g., anesthesia trainees) just starting to learn TEE, as well as advanced users searching for a complete reference book, will find the Comprehensive Textbook of Perioperative Transesophageal Echocardiography a highly useful addition to their library. Roman M. Sniecinski, MD, FASE Department of Anesthesiology Emory University Hospital Atlanta, Georgia email protected