Comparing Cardiac Chamber Measurements: TTE vs. TEE Under Anesthesia

NCT06715371 | Recruiting

• 1 other identifier: 6347
• Study Type: observational
• Target: 114
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare two common ultrasound techniques used during heart surgery: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). TTE is performed by placing an ultrasound probe on the chest, while TEE involves inserting a probe into the esophagus, which provides closer and clearer images of the heart. Both methods are part of routine care for patients undergoing heart surgery. The goal of this study is to assess how well the measurements from TTE and TEE agree in evaluating heart chamber dimensions during surgery and to investigate how factors such as anesthesia, breathing techniques affect these measurements. This research involves 114 adult patients scheduled for heart surgery at Sunnybrook Health Sciences Centre. Participants will have TTE performed before and after surgery, and TEE will be conducted during surgery. All procedures are part of the usual standard of care. By comparing these imaging techniques, the study seeks to provide more accurate and up-to-date guidelines for cardiac measurements, ensuring better care for patients during heart surgery.

Conditions

Heart Chambers

Keywords

Cardiac Imaging; Cardiac Chamber Dimensions; General Anesthesia; Cardiac Surgery; Imaging Agreement; Diagnostic Accuracy; Perioperative Care; Echocardiography

Outcome Measures

Primary Outcomes (1)

• Correlation between preoperative TTE and intraoperative TEE measurements

  The correlation between preoperative transthoracic echocardiography (TTE) and intraoperative transesophageal echocardiography (TEE) measurements of cardiac chamber dimensions, including left ventricular internal dimensions, left atrial volume, and right atrial dimensions.

  Within 2 weeks prior to surgery and during surgery

Secondary Outcomes (3)

• Impact of general anesthesia on correlation between TTE and TEE.

  Within 2 weeks prior to surgery and during surgery

• Impact of PEEP on correlation between TTE and TEE

  Within 2 weeks prior to surgery and during surgery

• Impact of cardiac conditions on correlation between TTE and TEE.

  Within 2 weeks prior to surgery and during surgery

Study Arms (1)

Cardiac Surgery Patients

Patients undergoing cardiac surgery (eg., coronary revascularization) at Sunnybrook Health Sciences Centre.

Diagnostic Test: Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE)

Interventions

Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE) DIAGNOSTIC_TEST

Transthoracic echocardiography (TTE) is a non-invasive imaging technique performed by placing an ultrasound transducer on the chest to obtain detailed heart images. TTE is conducted preoperatively on awake patients within two weeks prior to cardiac surgery, following ASE chamber quantification guidelines. Transesophageal echocardiography (TEE) is an invasive imaging technique where an ultrasound transducer is placed in the esophagus, providing closer and clearer images of the heart. TEE is performed intraoperatively under general anesthesia as part of routine care.

Also known as: Transthoracic Echocardiography (TTE), Transesophageal Echocardiography (TEE)

Cardiac Surgery Patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients undergoing elective cardiac surgery, specifically coronary revascularization procedures.

You may qualify if:

• Age ≥ 18, able to provide informed consent.
• Patients scheduled for coronary revascularization cardiac surgery under general anesthesia.
• With normal left ventricular (LV) systolic function, defined by an ejection fraction of 50% or more, and normal right ventricular (RV) systolic function.
• Requiring intraoperative echocardiographic assessment.

You may not qualify if:

• Patients with contraindications to either transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE).
• History of poor-quality echocardiography data that preclude accurate assessment.
• Undergoing emergency cardiac surgery.

Sponsors & Collaborators

• Sunnybrook Health Sciences Centre: lead

Study Sites (1)

Sunnybrook Health Sciences Centre

Toronto, Ontario, M4N 3M5, Canada

RECRUITING

Related Publications (9)

• Kabirdas D, Scridon C, Brenes JC, Hernandez AV, Novaro GM, Asher CR. Accuracy of transthoracic echocardiography for the measurement of the ascending aorta: comparison with transesophageal echocardiography. Clin Cardiol. 2010 Aug;33(8):502-7. doi: 10.1002/clc.20807.

  PMID: 20734448 BACKGROUND

• Singh H, Jain AC, Bhumbla DK, Failinger C. Comparison of left atrial dimensions by transesophageal and transthoracic echocardiography. Echocardiography. 2005 Nov;22(10):789-96. doi: 10.1111/j.1540-8175.2005.00128.x.

  PMID: 16343160 BACKGROUND

• Shiran A, Adawi S, Ganaeem M, Asmer E. Accuracy and reproducibility of left ventricular outflow tract diameter measurement using transthoracic when compared with transesophageal echocardiography in systole and diastole. Eur J Echocardiogr. 2009 Mar;10(2):319-24. doi: 10.1093/ejechocard/jen254. Epub 2008 Oct 2.

  PMID: 18835821 BACKGROUND

• Block M, Hourigan L, Bellows WH, Reeves J 3rd, Romson JL, Tran M, Pastor D, Schiller NB, Leung JM. Comparison of left atrial dimensions by transesophageal and transthoracic echocardiography. J Am Soc Echocardiogr. 2002 Feb;15(2):143-9. doi: 10.1067/mje.2002.121399.

  PMID: 11836489 BACKGROUND

• Assanangkornchai N, Villeneuve V, McDonald S, Magder S, Shum Tim D, Buithieu J, Hatzakorzian R. Interchangeability of transthoracic and transesophageal echocardiographic right heart measurements in the perioperative setting and correlation with hemodynamic parameters. Int J Cardiovasc Imaging. 2023 Mar;39(3):555-563. doi: 10.1007/s10554-022-02754-1. Epub 2022 Nov 18.

  PMID: 36399180 BACKGROUND

• Skarvan K, Lambert A, Filipovic M, Seeberger M. Reference values for left ventricular function in subjects under general anaesthesia and controlled ventilation assessed by two-dimensional transoesophageal echocardiography. Eur J Anaesthesiol. 2001 Nov;18(11):713-22. doi: 10.1046/j.1365-2346.2001.00915.x.

  PMID: 11580777 BACKGROUND

• Cohen GI, White M, Sochowski RA, Klein AL, Bridge PD, Stewart WJ, Chan KL. Reference values for normal adult transesophageal echocardiographic measurements. J Am Soc Echocardiogr. 1995 May-Jun;8(3):221-30. doi: 10.1016/s0894-7317(05)80031-8.

  PMID: 7640014 BACKGROUND

• Teran F, Prats MI, Nelson BP, Kessler R, Blaivas M, Peberdy MA, Shillcutt SK, Arntfield RT, Bahner D. Focused Transesophageal Echocardiography During Cardiac Arrest Resuscitation: JACC Review Topic of the Week. J Am Coll Cardiol. 2020 Aug 11;76(6):745-754. doi: 10.1016/j.jacc.2020.05.074.

  PMID: 32762909 BACKGROUND

• Giron-Arango L, D'Empaire PP. Is There a Role for Transesophageal Echocardiography in the Perioperative Trauma Patient? Curr Anesthesiol Rep. 2022;12(2):210-216. doi: 10.1007/s40140-022-00526-0. Epub 2022 Mar 19.

  PMID: 35340714 BACKGROUND

MeSH Terms

Interventions

Echocardiography; Echocardiography, Transesophageal

Intervention Hierarchy (Ancestors)

Cardiac Imaging Techniques; Diagnostic Imaging; Diagnostic Techniques and Procedures; Diagnosis; Ultrasonography; Heart Function Tests; Diagnostic Techniques, Cardiovascular

Study Officials

• Jacobo Moreno Garijo, MD, PhD

  Sunnybrook Health Science Centre

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jacobo Moreno Garijo, MD, PhD

CONTACT

416-480-4864; jacobo.morenogarijo@sunnybrook.ca

Lilia Kaustov, PhD

CONTACT

416-480-6100; lilia.kaustov@sunnybrook.ca

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 28, 2024
• First Posted: December 4, 2024
• Study Start: January 27, 2025
• Primary Completion: March 2, 2026
• Study Completion (Estimated): June 1, 2026
• Last Updated: July 3, 2025

Record last verified: 2024-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: Data will be available following publication of the full trial results.
• Access Criteria: Data and supporting information will be made available following reasonable request directly to study PI.

Locations

CA (1)