Assessment of systematic use of intraoperative transesophageal echocardiography during cardiac surgery in adults: A prospective study of 203 patients

Objective: To determine the usefulness of systematic intraoperative transes ophageal echocardiography in a cardiac surgical unit. Design: Open prospective observational survey. Setting: University Hospital. Participants: Consecutive adult patients (n = 203) undergoing elective or u rgent cardiac operations. Measurements and Main Results: Pre-cardiopulmonary bypass imaging yielded u nsuspected findings in 26 patients (12.8%) and changed the planned surgery in 22 patients (10.8%). Transesophageal echocardiography modified the diagn osis in eight patients (17%) operated on for mitral valvulopathy, in seven patients (15.5%) with aortic valvular disease, in four patients (4.6%) with coronary artery disease, in five patients operated on for thoracic aorta d iseases regardless of their localization (18.5%), and in two miscellaneous cases. On the basis of the data obtained from the transesophageal echocardi ography carried out at the end of cardiopulmonary bypass, an immediate rein tervention was required in five cases (2.5%). Conclusions: It is concluded that systematic intraoperative transesophageal echocardiography significantly affected decision making in this cardiac su rgical unit. Its routine use in all cardiac surgical patients is recommende d. Copyright (C) 2000 by W.B. Saunders Company.