Taped Live Case
Watch a live hTEE case unfold with Dennis Ashley MD from The Medical Center of Central Georgia (MCCG).
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Photo Gallery
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D. Benjamin Christie MD from The Medical Center of Central Georgia presenting at first hTEE Trauma Symposium in Scottsdale, Arizona.
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The live hTEE case demonstration by Dennis Ashley MD from MCCG of actual hTEE exam during the hTEE Trauma Symposium.
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Kristy Kuhl, Program Manager at ImaCor Inc answering questions during SCCM.
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hTEE focus group discussion at the SCCM moderated by Nicholas Cavarocchi MD from Thomas Jefferson University Hospital and Michael Pinsky MD of University of Pittsburgh Medical Center (both seated at far end of this photo)
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Surgeons visiting the ImaCor table during STS Tech-Con
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Contact Us
info@imacorinc.com
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Contributions
Should you wish to submit an article to our next monthly newsletter, please contact Sheila McGarrigle at newsletter@imacorinc.com.
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 Introduction by Scott Roth MD, Co-Founder & Chief Medical Officer ImaCor Inc. 
ImaCor is pleased to announce the completion of the first international, multicenter study of the hTEE system (Antoine Vieillard-Baron et al., Intensive Care Medicine, January 2013). Four leading intensivists (Antoine Vieillard-Baron MD PhD, Michel Slama MD PhD, Philippe Vignon MD PhD from France and Paul Mayo MD from the US) used the hTEE system in 94 patients, performing an average of 2.8 hemodynamic assessments per patient, over an average duration of 32-hours. "Among the 263 hemodynamic assessments, 132 (50 %) had a direct therapeutic impact in 62 patients (66 %)." In addition to this direct therapeutic impact, hTEE "allowed the confirmation that ongoing treatment was well adapted to the hemodynamic profile." This study confirms what we have seen clinically as hTEE applies broadly across multiple patient populations in critical care and perioperative medicine. Here the authors note that "Eighty-one patients (86 %) had circulatory failure (septic shock in 57 patients, cardiogenic shock in 7 patients, post-resuscitation syndrome in 13 patients, hemorrhagic shock in 4 patients), and the remaining 13 patients (14 %) were ventilated for ALI/ARDS."
This study represents another major milestone in the adoption of hTEE in the care of the critically ill. Congratulations to the authors in showing this major therapeutic impact, and we look forward to further reports on their work.
A pilot study on safety and clinical utility
of a single-use 72-hour indwelling
transesophageal echocardiography probe
Antoine Vieillard-Baron MD PhD, et al.
(Excerpted, please click to link to full study)
Abstract
Purpose:
To evaluate the hemodynamic monitoring capability and safety of a single-use miniaturized transesophageal echocardiography (TEE) probe left in place in ventilated critically ill patients.
Methods:
The probe was inserted in 94 patients and designed to be left in place for up to 72 h. Three views were obtained: the superior vena cava transverse, the midesophageal four-chamber, and the transgastric mid-papillary short-axis views. Observational data on the feasibility of insertion, complications, image quality, and influence on management were recorded and analyzed.
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hTEE in Trauma: How We are Building for the Future
 | R. Shayn Martin MD
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By Robert Shayn Martin MD
Wake Forest University Baptist Medical Center
(Excerpted, please click link for full article)
INDIRECT VERSUS DIRECT (TEE) ASSESSMENT
In the absence of TEE, we have traditionally used right heart measurements to deduce left heart characteristics which required multiple assumptions. Echocardiography allows the left heart to be visualized directly, providing information to drive resuscitation decisions. hTEE lets us obtain this valuable data in a fashion that fits within the workflow of a resuscitation in the ICU.
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Initial Experience With ImaCor hTEE-Guided Management of Patients Following Transplant and Mechanical Circulatory Support*
Christopher Kang MD, et al.
THE PATIENT
- 55 y/o female
- History of dilated cardiomyopathy, presented for a heart transplantation evaluation
- Decompensated into multiple organ failure despite significant inotropic support
MANAGEMENT
- Placed on emergent VA ECMO (Figure A)
- Not suitable for transplant; needed to evaluate RV function to bridge to ECMO
- Weaned using hTEE-guided protocol
- Over four hours, ECMO flows were decreased, and volume and dobutamine were administered
CONCLUSION
- hTEE showed that the right heart was adequate to tolerate a bridge to LVAD (Figure B). The patient was successfully weaned off ECMO and bridged to an LVAD as predicted.
*Adapted from Kang C, Hirose H, Hastings HM, Cavarocchi NC, ICU Director, published online 22 August 2012; also presented at SCCM 2012.
   
Back to Top
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ImaCor launched its 2013 Educational Program in mid-January with the hTEE Trauma Symposium, held at the EAST Annual Scientific Assembly in Scottsdale, Arizona. Trauma surgeons from across the country gathered together to learn the impact hTEE has made in trauma programs at the University of Alabama, Wake Forest University, and The Medical Center of Central Georgia. Attendees of the symposium watched via a live broadcast as an hTEE case unfolded in real time, and Dennis Ashley MD demonstrated the hTEE exam. The audience watched closely as Dr. Ashley acquired the three hTEE views, and described how hTEE information guided his therapeutic intervention. Thanks to Dennis Ashley MD, Don Reiff MD, R. Shayn Martin MD, and D. Benjamin Christie III MD for their contribution and expertise.
The educational program continued as cardiothoracic surgeons at STS joined us for the hTEE Cardiac Support Symposium just after dawn on January 28th. The event was hosted by Nicholas Cavarocchi MD of Thomas Jefferson University Hospital and Simon Maltais MD PhD of Vanderbilt University Medical Center. The feedback was overwhelmingly positive with both Dr. Maltais and Dr. Cavarocchi recommending that participants apply hTEE to their VAD and ECMO patients, as well as all patients with symptoms of right side dysfunction. With over 270 hTEE exams performed at Vanderbilt, hTEE is an essential tool in managing hemodynamic instability. "hTEE is the cornerstone of our ICU," remarked Dr. Maltais.
We remain committed to a quality clinical implementation. We actively engage our physician-users to refine best practices in introducing and using hTEE. To that end, over 20 critical care leaders joined our focus group discussion during the Society of Critical Care Medicine (SCCM) annual meeting in San Juan, Puerto Rico. The conversation centered around expanding clinical adoption of hTEE, demonstrating cost savings to hospital administrators, and positioning hTEE for 2014 and beyond.
Throughout all of these educational initiatives, we have heard from our key customers that using hTEE has saved lives and money in their ICUs. hTEE has shown significant value in managing suspected RV dysfunction to avoid RV failure. As such, you'll see more of our work to 'Save the RV with hTEE'.
Our body of clinical research continues to grow. I encourage you to read, if you have not already done so, the independent, multicenter study led by Antoine Vieillard-Baron MD PhD on the efficacy of the hTEE ClariTEE probe. Over 66% of the patients studied had a direct therapeutic impact based on the hemodynamic assessments with hTEE. This is the first study among many to follow that elucidates the value of hTEE for optimal patient outcomes.
Keep an eye out for a Special Edition of our newsletter, due out in mid-February, which will share in-depth what we learned at our January educational events.
With kind regards,
Peter Pellerito
President & CEO
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