Ecocardiografía transesofágica intraoperatoria en la cirugía de las cardiopatías congénitas

introduction. the intraoperative transesophageal echocardiography is very used in pediatric cardiovascular surgery. the aim of present paper was to determine its impact on the surgery immediate results after a previous experience of authors with this type of procedure. methods. reports of intraoperative transesophageal echocardiography in 231 consecutive patients between august, 2004 and december, 2007were retrospectively analyzed. authors determined the incidence of new diagnoses before cannulation, the impact of the transesophageal echocardiography prior decannulation and the relation between to take up again the extracorporeal circulation assessed from the intraesophageal echocardiographic study and the surgical risk of patients, according to the rachs-2 scale. also, we specified exactly the case incidence in which the study before decannulation doesn't identified significant residues. results. the impact of examination before cannulation was of 2,6% and that of echocardiography carried out before decannulation was of 10,82%. a second run of extracorporeal circulation signaled by a transesophageal echocardiography before decannulation was more frequent in neonatal and valvular surgery and in the arteriosus truncus leading to significant residual pressure gradient, residual short circuit and valvular regurgitation. the 2, 3 and 4 rachs-1 categories showed the risk to take up again the extracorporeal circulation of 2,7; 2,25 and 11,5 times regarding the 1 category, respectively. conclusions. the beneficial effect of the transesophageal echocardiography use in the transoperative period of pediatric cardiovascular surgery was confirmed and it was demonstrated the need of to take up again the extracorporeal circulation by a second time to correct the significant residues indicated by transesophageal echocardiography, is more probable in patients with a great surgical risk.