To explore the application value of transesophageal echocardiography(TEE) in robotic cardiac surgical procedures requiring peripheral cardiopulmonary bypass (CPB).

TEE was performed in 110 heart disease patients underwent robotic cardiac surgical procedures requiring peripheral CPB. Before CPB, The results of transthoracic echocardiography (TTE) were validated and assisted the surgeon to further determine the operation plan. During the establish peripheral CPB, TEE was used to guide cannulation of the inferior vena cava (IVC), superior vena cava (SVC) by way of the femoral vein and right internal jugular vein. After cardiac resuscitation, TEE assessed the surgical efficacy, complications and exhaust status. The results were analyzed retrospectively.

All the operations were performed under robots, and 2 cases were transferred to right anterolateral incision. There were 7 discrepancies between TEE and TTE, and the accuracy of TEE was 100% proven by surgery. TEE guided cannulation of the IVC or SVC was successful in all patients (100%) and no venous cannulae was obstructed during CPB. 2 cases of ventricular septal defect had residual shunt after cardiac resuscitation, 1 case had moderate regurgitation after mitral valvuloplasty, and 1 case had perivalvular leakage after aortic valve replacement. Satisfactory results were achieved after aortic cross-clamping again. The other patients had definite surgical effect, and TTE confirmed that there were no operative complications.

TEE can improve the success rate and safety of robotic cardiac surgery requiring peripheral CPB, and is an effective means of intraoperative diagnosis.