title: Role of intraoperative transesophageal echocardiography in patients having coronary artery bypass graft surgery.
abstract: 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.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Fatema E
authors.initials: FE
authors.lastname: Qaddoura
authors.forename: Martin D
authors.initials: MD
authors.lastname: Abel
authors.forename: Karen L
authors.initials: KL
authors.lastname: Mecklenburg
authors.forename: Krishnaswamy
authors.initials: K
authors.lastname: Chandrasekaran
authors.forename: Hartzell V
authors.initials: HV
authors.lastname: Schaff
authors.forename: Kenton J
authors.initials: KJ
authors.lastname: Zehr
authors.forename: Thoralf M
authors.initials: TM
authors.lastname: Sundt
authors.forename: Roger L
authors.initials: RL
authors.lastname: Click
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery; D003657:Decision Making; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018084:Ultrasonography, Interventional