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Ann Thorac Surg 2004;78:1586-1590
© 2004 The Society of Thoracic Surgeons

Original article: cardiovascular

Role of Intraoperative Transesophageal Echocardiography in Patients Having Coronary Artery Bypass Graft Surgery

Fatema E. Qaddoura, MDb, Martin D. Abel, MDa, Karen L. Mecklenburg, MDa, Krishnaswamy Chandrasekaran, MDb, Hartzell V. Schaff, MDc, Kenton J. Zehr, MDc, Thoralf M. Sundt, MDc, Roger L. Click, MD, PhDb,*

a Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA
b Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
c Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA

Accepted for publication May 3, 2004.

* Address reprint requests to Dr Click, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA 55905
click.roger{at}mayo.edu

BACKGROUND: Previous studies have shown that intraoperative transesophageal echocardiography provides important preoperative and postoperative information in various cardiac and noncardiac surgeries that may alter patient management and outcome. The role of intraoperative transesophageal echocardiography in patients in whom isolated coronary artery bypass graft surgery is anticipated has been reported only in small selected groups. This study was designed to prospectively evaluate the role of intraoperative transesophageal echocardiography in a large, nonselected group of patients undergoing primarily coronary artery bypass graft surgery.

METHODS: From January 2001 to December 2003, 474 consecutive patients (76% men, 24% women) aged 30 to 89 years (mean age of 70 ± 10 years) who were undergoing coronary artery bypass graft surgery had prebypass and postbypass intraoperative transesophageal echocardiography. New findings and alterations in the surgical plan were documented prospectively.

RESULTS: New prebypass findings were found in 10% of patients, and the surgical plan was altered in 3.4% of patients. New postbypass findings were found in 3.2% of patients, altering the surgical plan in 2% of patients.

CONCLUSIONS: This large consecutive, nonselected, prospective study reveals the significant impact of intraoperative transesophageal echocardiography in patients having coronary artery bypass graft surgery as a primary procedure. New findings (prebypass and postbypass) were found in 13% of patients overall, and the surgical plan was altered in 5.5% of patients. This study supports the use of intraoperative transesophageal echocardiography in patients undergoing primarily coronary artery bypass graft surgery.




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