Role of echocardiography in perioperative management of patients undergoing open heart surgery.

TEE has assumed a pivotal role in the perioperative management of patients undergoing open-heart surgery. The information obtained influences important therapeutic decisions in thoracic aortic surgery, valvular surgery, and coronary artery bypass surgery. TEE also assists in determining the reason for failure to wean from cardiopulmonary bypass and allows rapid detection of the etiology of hypotension in the patient after surgery. Advances in technology have resulted in three-dimensional images of cardiac structures, and this will further enhance the usefulness of echocardiography for the surgeon. TEE should no longer be regarded as an imaging tool available only in academic centers, but should be routinely used by qualified operators in centers performing open-heart surgery.