Intraoperative transesophageal echocardiography during cardiovascular surgery:experience from 493 cases / 中华麻醉学杂志

ABSTRACT

From June 1997 to June 2001 intraoperative transesophageal echocardiography(TEE)was used in 493 patients undergoing different cardiovascular operations including correction of congenital heart defect, coronary artery bypass grafting(CABG),cardiac valve replacement and major vascular surgery.The clinical data of these cases were complete and detailed enough for retrospective review.Their cardiac functions were graded to be classⅡ-Ⅳaccording to New York Heart Association(NYHA)classification.The patients ranged in age between 1.6-74 yrs and weighed between 8.5-92 kg.The probe of TEE was inserted in esophagus after tracheal intubation.Preoperative diagnosis was found to be wrong by TEE in 20 cases(4.1%).Additional defect was found in 51 cases(10.3%).The type of operation planned before operation was altered in 52 cases(10.5%). During the operation real time TEE revealed that the operation performed failed to achieve the goal and revision surgery was needed in 24 cases(4.9%).Abnormal hemodynamics and cardiac function were found by TEE after the heart resumed spontaneous beat in 17 cases(3.5%)and appropriate treatment was instituted.Oral and pharyngeal mucous membrane bleeding occurred in 7 cases.There were no serious complications attributable to TEE.Intraoperative TEE is a very useful tool in formulating the surgery,monitoring hemodynamics and assessing immediate results of surgery and is safe and reliable in the hands of trained anesthesiologists.