The Utility of Intraoperative Transesophageal Echocardiography in Cardiac Valve Surgery

pp 467-476

Abstract

Methods

The utility of the biplane transesophageal echocardiography was evaluated during operation on 60patients subjected to cardiac surgery with valve disease of various etiologies. In all patients the decision to carry out transesophageal echocardiography was made previous to surgery based, in each case, on the potential benefit of the method. The mean age of the patients was57±12.3years(23-75);29were females and 31, males. Repair of the mitral valve was performed in 30 cases, mitral commisurotomy in 5,aortic valve repair in 5, replacement of mitral valve in 8, replacement of aortic valve in 6, double mitral-aortic replacement in 5, and other procedures in 26 patients. The in-hospital operative mortality was 8.33%. In all cases the transesophageal echocardiography study was performed be-fore and after cardiopulmonary bypass. 

Results

The transesophageal echocardiography information previous to bypass was useful in modifying the pre-operative surgical plan in 10 patients (16.7%). New findings which did not modify the plan were observed in 11 patients (18.3%) and non-satisfactory in 7 patients (11.7%). Immediate reintervention was practised in 6 patients (10%). The method was determinant in the surgical strategy to be followed in14 patients(23.3%).No secondary complications were observed.

Conclusions

The intraoperative transesophageal echocardiography proved to be a valuable method to confirm or modify the surgical plan and detect immediate unsatisfactory results after bypass during valvular surgery in this population.