THE ROLE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE MONITORING OF CARDIAC MASS REMOVAL - A REVIEW OF 17 CASES

Intraoperative transesophageal echocardiography (TEE) was used to moni tor the removal of intracardiac masses in 17 patients. Prebypass TEE w as used to confirm the preoperative diagnosis. It gave a clear image a nd anatomical definition of the mass in 16 cases. Moreover, in 11 of t hese patients, prebypass TEE provided information not obtained previou sly by traditional exams. This information was judged either useful or indispensable for a successful outcome in 10 of these patients. Howev er, in one of the remaining six patients, TEE did not clearly visualiz e a flat thrombus in the left atrium. Postbypass TEE was used in each case to monitor the surgical results of the mass removal and the assoc iated procedures. In one patient, it disclosed a progressively expandi ng hematoma in the left atrial wall, which was interfering with mitral valve function. From this experience, we consider intraoperative TEE the best monitoring device during cardiac mass removal because it usua lly provides a more complete diagnosis and anatomical definition of th e mass than the traditional preoperative methods and permits monitorin g of the surgical results before chest closure. Some limitations to th is method may exist.