Background: We evaluated the value of transesophageal echocardiography (TEE) in monitoring the placement of intra-aortic balloon pump (IABP) and in reducing its complications.

Methods: The study included 34 patients (15 females, 19 males; mean age 62 years; range 42 to 83 years) who underwent intraoperative IABP placement. The position of the IABP was monitored by TEE in 22 patients (65%). Twelve patients did not meet the criteria for TEE use. The two groups were assessed with respect to perioperative and postoperative IABP-related complications.

Results: Of 22 patients who were monitored by TEE during IABP placement, 17 patients (77%) required further interventions concerning the replacement or repositioning of the IABP. In five patients, there was no need for any intervention. In this group, four patients (18%) died in the early postoperative period due to low cardiac output. Among those who were not monitored by TEE during IABP placement, three patients (25%) died in the intensive care unit due to low cardiac output and multiorgan failure and/or sepsis.

Conclusion: In recent years the use of the IABP in cardiac surgery has increased. It has an important role especially during weaning from cardiopulmonary bypass. To obtain the maximum benefit from the IABP and to avoid IABPrelated complications, the correct placement and positioning of the IABP should be monitored by TEE.

Keywords : Echocardiography, transesophageal; heart surgery; intra-aortic balloon pumping