Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anesthesia

This study is based on the hypothesis that the routine use of transesophageal echocardiography in cardiac surgery will influence the surgical decision taken by the surgeon intraoperative in Kasr Al-Ainy. Study design: Patients were examined with IOTEE before and after cardiopulmonary bypass. Complete and comprehensive intraoperative TEE examinations will be performed by TEE certified cardiac anesthesiologists. Data that will be collected from the intraoperative examination will be compared with preoperative transthoracic echocardiography and the surgical decision that was taken preoperatively will be revised again with cardiothoracic surgeon before the start of surgery. Also, TEE will be used again after weaning from bypass for revision and assessment of our decision. Results: We examined the utility of TEE in 100 selected patients undergoing different types of cardiac procedures in Kasr Al-Ainy hospital. This prospective clinical investigation found that the pre- and post-CPB TEE examinations influenced surgical decision making in 10% of all evaluated patients. Conclusion: Intraoperative TEE has the potential to significantly influence clinical decision making for cardiac surgical patients. It is useful in surgical planning, guiding various hemodynamic interventions, and assessing the immediate results of surgery. Thus, IOTEE should be used routinely in all patients undergoing all types of cardiac surgeries

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