Intraoperative transoesophageal echocardiography: impact on adult cardiac surgery.

Although multiple case reports have demonstrated the capability of transoesophageal echocardiography (TOE) to detect unsuspected cardiac pathology with important therapeutic implications, few studies have examined the effect of real-time interpretation of routine TOE on clinical management of a typical series of cardiac surgery patients. To assess the impact of intraoperative TOE on cardiac surgical management, we conducted a prospective observational study on 238 consecutive patients undergoing intraoperative TOE during adult cardiac surgery. Potentially important new diagnostic information was detected in 39 of 184 (21%) routine and in 53 of 54 requested TOE examinations, and led directly to different surgical procedures in 11 of 184 (6%) routine and in 12 of 54 (22%) requested TOE examinations. Our data suggests that intraoperative TOE may be a valuable tool in the routine management of adult cardiac surgical patients.