I HAVE BEEN HAVING TROUBLE WITH THSES FOLLOW-UP TEE'S, AND THE NEW TEE CODE 93355, CAN SOMEONE TAKE A LOOK AT THIS DICTATION AND TELL ME IF WOULD STILL CODE THIS TEE AS 93314.26,93325.26...BECAUSE 93355 DOES NOT INCLUDE THE PROBE INSERTION, JUST PROBE MANIPULATION.
PROCEDURE PERFORMED: Intraoperative transesophageal.
INDICATION: An man, who has severe aortic valve stenosis. The
patient has requested intraoperative TEE to assess aortic anulus diameter.
DESCRIPTION OF PROCEDURE: Informed consent was obtained from the TAVR team
with the patient under general anesthesia. Initial difficulty in placing
the probe __________, but under laryngoscope by the anesthesiologist, the
multifrequency probe was successfully inserted by Dr. The
cardiac chambers were viewed. Agitated saline was given by IV for echo
contrast effect. The probe was left in place for the rest of the study.
COMPLICATIONS: No obvious pharyngeal or esophageal trauma.
RESULTS:
1. Left ventricle: Normal left ventricular size with normal systolic
function. Ejection fraction of 60%. No thrombus or mass.
2. Right ventricle: Normal size and systolic function.
3. Aortic valve: Heavy calcification of trileaflet aortic valve. The
aortic valve annulus is measured 26 x 20 mm with an area of 4.2 cm2.
There is mild-to-moderate central regurgitation.
4. Mitral valve: Grossly normal with mild regurgitation.
5. Tricuspid valve: Grossly normal.
6. Pulmonic valve: No regurgitation.
7. Atria: Moderate left atrial enlargement, diameter 49 x 44 mm, mild
right atrial enlargement diameter of 43 x 41 mm. No obvious
interatrial septal shunting by color flow by agitated saline. The left
atrial appendage is free of thrombus or mass.
8. Aorta: Normal aortic root, diameter sinuses 33 mm, sinotubular
junction 26 mm, and ascending aorta 33 mm.
9. Pericardium: Normal without effusion.
PROCEDURE PERFORMED: Intraoperative transesophageal.
INDICATION: An man, who has severe aortic valve stenosis. The
patient has requested intraoperative TEE to assess aortic anulus diameter.
DESCRIPTION OF PROCEDURE: Informed consent was obtained from the TAVR team
with the patient under general anesthesia. Initial difficulty in placing
the probe __________, but under laryngoscope by the anesthesiologist, the
multifrequency probe was successfully inserted by Dr. The
cardiac chambers were viewed. Agitated saline was given by IV for echo
contrast effect. The probe was left in place for the rest of the study.
COMPLICATIONS: No obvious pharyngeal or esophageal trauma.
RESULTS:
1. Left ventricle: Normal left ventricular size with normal systolic
function. Ejection fraction of 60%. No thrombus or mass.
2. Right ventricle: Normal size and systolic function.
3. Aortic valve: Heavy calcification of trileaflet aortic valve. The
aortic valve annulus is measured 26 x 20 mm with an area of 4.2 cm2.
There is mild-to-moderate central regurgitation.
4. Mitral valve: Grossly normal with mild regurgitation.
5. Tricuspid valve: Grossly normal.
6. Pulmonic valve: No regurgitation.
7. Atria: Moderate left atrial enlargement, diameter 49 x 44 mm, mild
right atrial enlargement diameter of 43 x 41 mm. No obvious
interatrial septal shunting by color flow by agitated saline. The left
atrial appendage is free of thrombus or mass.
8. Aorta: Normal aortic root, diameter sinuses 33 mm, sinotubular
junction 26 mm, and ascending aorta 33 mm.
9. Pericardium: Normal without effusion.
