[Transesophageal echocardiography during coronary bypass surgery]

Transesophageal two-dimensional echocardiography (TEE) was evaluated in 14 patients who underwent coronary bypass surgery. The TEE transducer was positioned to view the left ventricular short axis at the level of the papillary muscle. Global left ventricular function was assessed by measuring left ventricular end-diastolic and end-systolic area and computing the fractional area change (FAC). Regional left ventricular function was analyzed after dividing the short axis view of the left ventricle into four anatomic segments. The mean FAC was 48% after intubation, 48% after skin incision, 47% after sternotomy, and 51% after pericardiotomy. The mean FAC increased significantly to 55% 0 to 30 minutes after cardiopulmonary bypass, and was 53% at the end of the operation. In 5 patients, FAC decreased and regional wall motion abnormalities appeared around sternotomy. These abnormalities was considered due to transient myocardial ischemia. In 7 patients, a paradoxical motion of the ventricular septum occurred at closing of the sternum. TEE was performed without complication and found to be a good method for assessing global and regional left ventricular function.