The utility of transesophageal echocardiography in the evaluation of hypotension in the postoperative period after coronary artery bypass was assessed in 126 patients in the intensive care unit. There were 86 men and 40 women, with a mean age of 58.3 years. The indication for transesophageal echocardiography was hypotension refractory to conventional treatment. Valuable diagnostic information was obtained in 103 patients (82%). Based on the echocardiographic findings, 24 patients (19%) underwent urgent surgical intervention. The mean time required to obtain a diagnosis was 9.6 +/- 2.8 min. No significant complications were noted. Our experience suggests that transesophageal echocardiography is highly specific in diagnosing the cause of postoperative hypotension, thus preventing unnecessary surgical intervention and facilitating decision making in cardiac surgical emergencies.