Abstract

LEVIN, Ricardo L. et al. An Image is Worth a Thousand Numbers: Transesophageal Echocardiography Monitoring in Cardiac Surgery. Rev. argent. cardiol. [online]. 2015, vol.83, n.5, pp.441-445. ISSN 1850-3748.

Background: Transesophageal echocardiography (TEE), a technique with almost universal applicability, is being used with increasing frequency in the operating room, and the use of a miniaturized device for hemodynamic monitoring based on TEE is 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 TEE analyzing 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. Mediastinal hematoma 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 device helped 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 mediastinal hematoma could be managed with a conservative approach. The greatest benefit was achieved by patients under ventricular assist devices and by those undergoing delayed sternal closure. Further studies are necessary to determine the value of this technique.

Keywords : Hemodynamic Monitoring; Cardiac Surgery; Transesophageal Echocardiography.