Site-specific detection of bleeder using transesophageal echocardiography

Transesophageal echocardiography continues to be an indispensable postoperative diagnostic tool for cardiac surgical patients. Transesophageal echocardiography was carried out postoperatively in 30 consecutive hypotensive patients with low cardiac output who had undergone coronary bypass surgery. In 19 of these patients, a cause of low cardiac output requiring surgical intervention was excluded, and they were managed conservatively. In 11 patients, a surgical cause of low cardiac output was indicated: diffuse bleeding from no particular site in 5, and from a specific site in 6. They underwent urgent re-operation, and the echocardiography findings were confirmed on the operating table. Not only is transesophageal echocardiography important in diagnosis, but it is also highly specific in locating the site of bleeding.