TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN CARDIAC SURGICAL EMERGENCIES

The value and utility of transesophageal echocardiography (TEE) in uns table cardiac surgical patients have been assessed; 119 TEE studies we re performed and evaluated in the emergency setting, The studies were performed in the cardiac surgical intensive care unit (n = 62) and in the operating room (n = 57), There were 81 men and 38 women with a mea n age of 58.2 years. The indications for TEE were as follows: hypotens ion refractory to conventional treatment (n = 83); prosthetic or nativ e valve dysfunction (n = 25); and suspected aortic dissection (n = 10) . TEE provided valuable diagnostic information in 107 patients and was completely normal in 12 patients, Based on these results 22 patients had urgent surgical intervention without further studies. The average time to diagnosis was 11.2 minutes, No significant complications were noted, Our results suggest that TEE is highly diagnostic for most of t he abnormalities responsible for hemodynamic instability in the periop erative period and facilitates decision making in cardiac surgical eme rgencies.