RESUMEN
Background: Transesophageal echocardiography allows a semi-invasive hemodynamic monitoring, during cardiac and non cardiac surgery. The benefits of such surveillance must be assessed, since it may help to change patient management. Aim: To assess the usefulness of transesophageal echocardiography during surgical procedures in critical patients. Material and methods: Based on the indications of the North American Societies of Cardiology and Anesthesiology, 264 patients were monitored using a multiplanar transducer. The type of surgery, insertion difficulties, quality of visualization, complications and usefulness of the method were recorded. Results: One hundred eleven cardiac and 153 non cardiac surgical procedures were monitored. In 97 percent of cases, visualization was good. In 2 cases, it was impossible to obtain a transgastric axis. No complications of the procedure were recorded. The method was useless in nine patients, helpful to change drug and volume management in 126 (48 percent) patients, helpful to change perioperative management in 49 (19 percent) patients and was a substitute for pulmonary artery catheterization in 79 (30 percent) patients. Conclusions: Intraoperative transesophageal echocardiography is a safe technique that renders high quality images, with a low incidence of complications and that, when well indicated, orients therapeutic changes in 98 percent of patients.