title: Impact of intraoperative transesophageal echocardiography in mortality in coronary artery bypass grafting.
abstract: OBJECTIVE
  To evaluate the rates of mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) using routine intraoperative transesophageal echocardiography (ITEE).
  
  
  METHODS
  We conducted a retrospective, observational review of medical records of 360 patients from April 2010 to April 2012. We analyzed: age, weight, height, gender, EuroSCORE, diabetes mellitus, ejection fraction and number of diseased vessels. Outcomes were compiled in intraoperative and postoperative (myocardial infarction, stroke, renal failure, hemodialysis, atrial fibrillation, length of stay in the intensive care unit).
  
  
  RESULTS
  53 patients were included, with 27 receiving monitoring; we excluded 307 individuals, as they were not operated by the same surgical team. The two groups were homogeneous for age, weight and gender. However, the ejection fraction was lower in the group submitted to ITEE (ITEE group 56.3% versus Non-ITEE group 65.9 ± 11%, p = 0.01). In patients not subjected to ITEE, mortality was higher (ITEE group 0% versus Non-ITEE group 7.6%, p = 0.01). There was no significant difference between groups as for the incidence of stroke, myocardial infarction, atrial fibrillation and acute kidney injury.
  
  
  CONCLUSIONS
  The use of intraoperative transesophageal echocardiography in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass decreased perioperative mortality, warranted the use of inotropic drugs and vasodilators and contributed to a better patient outcome.
authors.forename: Marcello Fonseca
authors.initials: MF
authors.lastname: Salgado Filho
authors.forename: Nubia
authors.initials: N
authors.lastname: Verçosa
authors.forename: Ismar Lima
authors.initials: IL
authors.lastname: Cavalcanti
authors.forename: Leonardo Augusto
authors.initials: LA
authors.lastname: Miana
authors.forename: Cleber Macharet
authors.initials: CM
authors.lastname: de Souza
authors.forename: Eduardo
authors.initials: E
authors.lastname: Borato
authors.forename: Izabela
authors.initials: I
authors.lastname: Palitot
mesh_terms: D001281:Atrial Fibrillation; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D012189:Retrospective Studies