[Transesophageal echocardiography in the operating room]

The need to optimize cardiac surgery performance combined with the capability that intraoperative transesophageal echocardiography (ETE) has to evaluate the surgical results in real time, without invading the operative field and with an image quality as good as epicardial echo, have led to the increasing use of this tool in the surgical setting. After describing the historical evolution and defining the leading indications to perform intraoperative echocardiography, the author reports his experience with intraoperative TEE. The echocardiographic evaluation of the surgically repaired mitral valve deserves particular attention as it represents the leading reason to perform intraoperative TEE in his experience. Between January 91 and January 98, 116 intraoperative TEE were performed, most of them (65%) in patients submitted to valvular surgery, particularly for the evaluation of reparative mitral valve surgery results (34%). The results of conservative surgery was considered satisfactory in 33 patients (82%) ad unsatisfactory in six (15%). These patients have had a second run of cardiopulmonary by-pass and a mitral prosthesis was implanted in all of them. Looking ahead, the author concludes with the importance that three-dimensional and myocardial contrast echocardiography will have on broadening the indications to perform intraoperative TEE.