TEE is a valuable tool for rapid perioperative diagnosis and management of severe hemodynamic instability, such as cement implantation syndrome, during high-risk orthopedic surgeries.
Supports TEE in cement implantation syndrome collapse; leaves open whether routine use improves outcomes in high-risk orthopedic procedures.
Femoral fractures are common and lethal among elderly patients. The elderly suffer more perioperative risks because of their complicated medical conditions and poor physical reserves. During cemented arthroplasty surgery in the elderly, unstable hemodynamic changes are frequently noted when the cement and prosthesis are inserted. Transesophageal echocardiography (TEE) allows rapid perioperative diagnosis and management of hemodynamic changes. We report an elderly patient with paroxysmal atrial fibrillation, in whom a huge serpentine embolus was noted by TEE. Although cardiovascular collapse was encountered during cemented hip arthroplasty surgery, the patient was successfully resuscitated and the related perioperative risk was managed by TEE application.
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Chen et al. (2008) studied this question.
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