Clinical Utility of Intraoperative Transesophageal Echocardiography for Crucial Monitoring and Hemodynamic Support in Patients with Low Cardiac Output- Tertiary Center Experience.
Fadel, A., Kamel, R., Abdul Azeem, E., Ismail, S. (2025). Clinical Utility of Intraoperative Transesophageal Echocardiography for Crucial Monitoring and Hemodynamic Support in Patients with Low Cardiac Output- Tertiary Center Experience.. EKB Journal Management System, 42(8), 51-60. doi: 10.21608/bmfj.2025.384932.2411
Ahmed M. Fadel; Reda K. Kamel; Ehab S. Abdul Azeem; Samir E. Ismail. "Clinical Utility of Intraoperative Transesophageal Echocardiography for Crucial Monitoring and Hemodynamic Support in Patients with Low Cardiac Output- Tertiary Center Experience.". EKB Journal Management System, 42, 8, 2025, 51-60. doi: 10.21608/bmfj.2025.384932.2411
Fadel, A., Kamel, R., Abdul Azeem, E., Ismail, S. (2025). 'Clinical Utility of Intraoperative Transesophageal Echocardiography for Crucial Monitoring and Hemodynamic Support in Patients with Low Cardiac Output- Tertiary Center Experience.', EKB Journal Management System, 42(8), pp. 51-60. doi: 10.21608/bmfj.2025.384932.2411
Fadel, A., Kamel, R., Abdul Azeem, E., Ismail, S. Clinical Utility of Intraoperative Transesophageal Echocardiography for Crucial Monitoring and Hemodynamic Support in Patients with Low Cardiac Output- Tertiary Center Experience.. EKB Journal Management System, 2025; 42(8): 51-60. doi: 10.21608/bmfj.2025.384932.2411

Clinical Utility of Intraoperative Transesophageal Echocardiography for Crucial Monitoring and Hemodynamic Support in Patients with Low Cardiac Output- Tertiary Center Experience.

Benha Medical Journal
Volume 42, Issue 8, August 2025, Pages 51-60    PDF (688.07 K)
Document Type: Original Article
DOI: 10.21608/bmfj.2025.384932.2411
Authors
Ahmed M. Fadel* 1; Reda K. Kamel2; Ehab S. Abdul Azeem3; Samir E. Ismail4
1Anesthesiology Department, Faculty of Medicine, Benha University, Benha, Egypt.
2Professor of anesthesia and intensive care Faculty of Medicine, Benha University
3Professor of anesthesia and intensive care Faculty of Medicine - Benha University
4Assistant professor of anesthesia and intensive care Faculty of Medicine - Benha University
Abstract
Background: Intraoperative Transoesophageal Echocardiography (TEE) is a valuable tool for guiding surgical decisions and managing hemodynamic instability in cardiac surgery. However, its role in improving clinical outcomes remains underexplored. Objectives: To evaluate the utility of TEE in monitoring cardiac function and guiding pharmacological and mechanical support in patients with low Left Ventricular Ejection Fraction (LVEF) undergoing cardiac surgery. Methods: This prospective observational study included 98 patients with LVEF <35% undergoing cardiac surgery at Benha University Hospitals (December 2022–December 2023). TEE was performed pre- and post-bypass to assess hemodynamic parameters, including Cardiac Output (COP), Systemic Vascular Resistance (SVR), and End-Diastolic Area (EDA). Primary outcomes included changes in COP and LVEF, while secondary outcomes involved pharmacological and mechanical support requirements. Results: Postoperative COP significantly increased (3.2 ± 0.7 to 5.3 ± 1.2 L/min, p < 0.001), while SVR significantly decreased (1563.8 ± 396.1 to 1032.5 ± 280.5 dyn.sec/cm⁵, p < 0.001). LVEF improved postoperatively (29.7 ± 5.7% to 41.2 ± 8.4%, p < 0.001). Vasopressors were required in 49.9% of patients, inotropes in 76.5%, and mechanical support in 13.2%. TEE identified new intraoperative pathologies in 9.2%, leading to surgical modifications. Conclusions: TEE provides real-time assessment of cardiac function, enabling precise intraoperative interventions that optimize hemodynamic stability and improve surgical outcomes in high-risk cardiac patients.
Keywords
TEE; Hemodynamic Support; LVEF; COP; Low EF
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