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USE OF TEE IN MINIMALLY INVASIVE CARDIAC SURGERY Dr. Hossam El Ashmawi Department of Anesthesia, Cairo University, Egypt The term “Minimally Invasive Cardiac Surgery” includes a range of surgical procedure including off-pump coronary artery bypass grafting (OPCAB), minimally invasive direct access coronary artery bypass grafting (MIDCAB), and Port access procedures. Such procedures are becoming more and more popular everyday. In OPCAB procedures TEE can be of help in assessing how well the ventricle is tolerating the procedure, which inevitably involves manipulation of the heart by the surgeon. Assessment of ischemia is very useful by TEE as positioning of the heart can interfere with ECG readings. In Minimally invasive procedures requiring cardiopulmonary bypass (CPB) and cardioplegia a number of catheters and cannulae are inserted. As this cannot be done under direct vision, TEE can be of help in verifying the correct positioning of these catheters. The aim of this presentation is to summarize the clinical applications and significance of TEE in minimally invasive cardiac procedures.