Transesophageal echocardiography in the anesthetic management of total hip arthroplasty

Total hip arthroplasty is a common procedure in the elderly and thromboembolism continues to be a cause of mortality and morbidity associated with this procedure. When properly diagnosed and treated the mortality rate from pulmonary embolism can be reduced significantly. Transesophageal echocardiograpic (TEE) detection of central pulmonary artery thromboemboli in patients with severe pulmonary embolism has been reported to have a sensitivity of 96.7% and a specificity of 88%. However TEE is not universally available due to its cost and expertise that is required. Taking into consideration its cost/effectiveness we suggest that in patients undergoing the cement type of total hip arthroplasty who are cardiopulmonary compromised, debilitated or elderly the use of TEE is indicated.