Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Systematic Review

Intraoperative transesophageal echocardiography following mitral valve repair: a systematic review

Ecocardiografia transesofágica intraoperatória após plastia valvar mitral: uma revisão sistemática

Raffael Zamper, Agya Prempeh, Ivan Iglesias, Ashraf Fayad

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We aimed to examine the recent evidence and search for novel assessments on intraoperative TEE following mitral valve repair that can impact short and long-term outcomes.

The Ovid MEDLINE, PubMed, and EMBASE databases were searched from January 1, 2008, until January 27, 2021, for studies on patients with severe Mitral Valve Regurgitation (MR) undergoing Mitral Valve (MV) repair surgery with intraoperative Transesophageal Echocardiography (TEE) performed after the repair. Additional searches were conducted using Google search engine, Web of Science, and Cochrane Library.

After reviewing 302 records, 8 retrospective and 22 prospective studies were included (n = 30). Due to clinical and methodological diversity, these studies are noncomparable and data were not amenable to quantitative synthesis.

Although technological advances allowed the objective assessment of geometric and dynamic alterations of the MV, the impact of the use of these technologies on short- or long-term outcomes was not studied. There is uncertainty and conflicting evidence on the ideal method and metrics to evaluate MV patency post-repair. Few isolated studies validated methods to assess coaptation surface and LV function post-repair.


Intraoperative transesophageal echocardiography;  TEE;  Mitral valve;  Mitral valve repair;  Systematic review


Objetivo: Nosso objetivo foi examinar as evidências recentes e buscar novas avaliações sobre a ETE intraoperatória após o reparo da valva mitral que podem impactar os resultados a curto e longo prazo. Métodos: As bases de dados Ovid MEDLINE, PubMed e EMBASE foram pesquisadas de 1º de janeiro de 2008 a 27 de janeiro de 2021, para estudos de pacientes com regurgitação mitral grave (RM) submetidos à cirurgia de reparo da valva mitral (VM) com ecocardiografia transesofágica intraoperatória (ETE) realizado após o reparo. Pesquisas adicionais foram realizadas usando o mecanismo de busca Google, Web of Science e Cochrane Library. Resultados: Após revisão de 302 registros, 8 estudos retrospectivos e 22 estudos prospectivos foram incluídos (n = 30). Devido à diversidade clínica e metodológica, esses estudos não são comparáveis e os dados não foram passíveis de síntese quantitativa. Conclusão: Embora os avanços tecnológicos tenham permitido a avaliação objetiva das alterações geométricas e dinâmicas da VM, não foi estudado o impacto do uso dessas tecnologias nos resultados a curto ou longo prazo. Há incerteza e evidências conflitantes sobre o método e as métricas ideais para avaliar a permeabilidade da VM após o reparo. Poucos estudos isolados validaram métodos para avaliar a superfície de coaptação e a função do VE pós-reparo.


Idade; Idoso; Transplante de fígado; Complicações pósoperatórias.


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