[Changes in therapeutic attitude based on transesophageal echocardiography in cardiac surgery]

Transesophageal echocardiography is a monitoring system that is changing the practice of cardiovascular anesthesia and surgery by providing real time images of cardiovascular anatomy and pathophysiology. Our hospital's anesthesiology and postoperative intensive care departments, in particular the cardiac anesthesia team, initiated a joint project in June 1993 with the echocardiography laboratory team to incorporate this surgical monitoring system. Here we report the wealth of information we obtained and describe the possibility of modifying a therapeutic approach based on the images visualized, even when conventional monitoring gives contradictory information. Two illustrative case reports are included.