The goal of the energetic cardiac anesthesiologist is to educate his colleagues and the community on the wonders of the Transesophageal Echocardiogram—also known as TEE.
The diagnostic procedure is the best way to look at the heart and its valves.”It offers a 4-D experience,” Dr. Roos explained. “That’s like 3-D in motion.”
That view comes courtesy of the Philips iE33, a new piece of equipment which was purchased and installed in April 2009, along with everything else in NorthBay Medical Center’s new Cardiovascular Operating Room.
“It’s just the best,” explained Dr. Roos. “It allows me to view the heart from every angle and in amazing detail.”
The procedure is minimally invasive. An “echo transducer” —probe—is placed in the esophagus, or swallowing tube, while a patient is mildly sedated. A little bit of anesthetic is used to numb the throat. The doctor is then able to shift the probe down the esophagus, and use ultrasound to see visuals of the heart. The probe can be rotated, to capture different angles.
A standard echocardiogram would involve placing a tranducer on the chest, but the ultrasound has to travel through skin, muscle, bone and lung tissue to “see” the heart, and that makes the image less detailed, explained Dr. Roos. In TEE, the transducer is in the swallowing tube that is right behind the heart and that makes the image quality unmatchable.
The procedure can be used both as a diagnostic tool, to determine possible risk factors, valve disorders, heart infections and best treatment scenarios, as well as a tool during surgery.
During surgery, Dr. Roos’ specialty is “hemodynamic management.” That means he’s watching to make sure the patient’s pulse, blood pressure and cardiac output are all on track. But the tool can do so much more.
“I can’t tell you how many patients I’ve seen in surgery, and I just know that if I’d had a chance to look at their heart five years earlier, they wouldn’t be in the operating room today but much earlier and the surgery would have been much easier.”
A leaky valve, for example, makes the heart work twice as hard. “The heart’s an amazing machine. It works nonstop for 90 years. But if you make it work twice as hard year after year, you’ll pay the price.”
To get to those patients who could benefit most from his iE33, he has to educate primary care doctors to send patients his way.
“It’s the gold standard for diagnosing valve disorders, but about 48 percent of patients with valve disorders never get referred,” he said.
“It’s under-diagnosed and under-managed. The public needs to know if they have a history of valve disorders, it’s easier than ever for us to check it out. It’s right on target with NorthBay’s mission of offering advanced medicine close to home.”