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Transesophageal echocardiography (TEE) is one of the cornerstones of cardiac imaging in inpatient and intra-operative settings. TEE is considered a safe procedure, but it may result in serious complications, such as esophageal injury, vocal cord paralysis, arrhythmia, hypotension, seizure, and cardiac arrest. Herein, we discuss one of the rare complications, esophageal perforation, and a conservative approach to managing the patient in a 64-year-old female who underwent a TEE prior to a scheduled valvular surgery.

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Background: Right ventricular (RV) function assessment by echocardiography can be challenging due to its complex morphology. Also, increasing use of sedation rather than general anesthesia for transfemoral approach transcatheter aortic valve replacement (TAVR) reduces the need for intraoperative transesophageal echocardiography (TEE). Recent clinical studies have demonstrated the importance of 3-dimensional (3D) echocardiography and a longitudinal strain for RV function assessment.

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Introduction: Many studies have shown that coronary artery bypass grafting (CABG) increases the survival rate of patients, but the effect of bypass grafting on cardiac function is still a matter of debate.

Objective: The objective of our study was to determine: a. To what extent can the change in coronary sinus flow be used as an intraoperative criterion for the assessment of adequate revascularization.

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