MacKay EJ, Neuman MD, Fleisher LA, et al. - This observational retrospective cohort study compared the clinical outcomes of individuals undergoing open cardiac valve repair or replacement surgery with and without transesophageal echocardiographic monitoring. Between January 1, 2010, and October 1, 2015, researchers applied Medicare claims to evaluate the correlation between perioperative transesophageal echocardiography (TEE) and 30-day all-cause mortality and length of hospitalization among patients undergoing open cardiac valve repair or replacement surgery. This study enrolled a sum of 219,238 patients who underwent open cardiac valve surgery, of whom 85% underwent TEE. Thirty-day mortality was determined by Medicare death records.  Without a significant increase in length of hospitalization, result demonstrates that transesophageal echocardiographic monitoring in cardiac valve repair or replacement surgery was correlated with lower 30-day risk-adjusted mortality. These data support the utility of TEE as routine practice in open cardiac valve repair or replacement surgery.