Intraoperative transesophageal echocardiography in valve replacement surgery.

Transesophageal echocardiography (TEE) is applied widely during heart valve replacement surgery. Intraoperative TEE (IOTEE) is used to formulate the surgical plan, assess cardiac function, and evaluate surgical outcome. This review describes the methodology of IOTEE, focusing on its role in valve replacement surgery. Specific aspects, such as its role in surgical decision making, selection of the prosthetic model and size, detection and quantification of paravalvular leaks, outflow tract obstruction, and acute prosthetic valve obstruction, are discussed. Furthermore, a description of the value of IOTEE in newer procedures, such as port access surgery, is presented.