An Image is Worth a Thousand Numbers. Transesophageal Echocardiography Monitoring in Cardiac Surgery

Background: Transesophageal echocardiography (TEE), a technique with almost universal applicability, is being used withincreasing frequency in the operating room, and the use of a miniaturized device for hemodynamic monitoring based on TEEis particularly useful in critically ill patients during the postoperative period.Objectives: The aim of this study was to evaluate the use of a miniaturized device for hemodynamic monitoring based on TEEanalyzing the number of patients evaluated, the hemodynamic findings and the associated complications.Methods: Unstable patients undergoing surgery were included between October 2010 and July 2012.Results: The device was used in 252/1,435 (17.6%) patients; hypovolemia was the main finding in 165 (73.4%) patients. Mediastinalhematoma was detected in 4 patients (1.6%) and resolved with conservative management. Eight patients (3.2%)under ventricular assist devices presented events. In the 27 patients (10.7%) undergoing delayed sternal closure, the devicehelped to determine the time to sternal closure. No associated complications were reported.Conclusions: This technique modified the initial diagnosis, and hypovolemia was the main finding. Patients with mediastinalhematoma could be managed with a conservative approach. The greatest benefit was achieved by patients under ventricularassist devices and by those undergoing delayed sternal closure. Further studies are necessary to determine the value of thistechnique.