[Intraoperative monitoring using transesophageal 2-dimensional echocardiography]

Currently used monitoring techniques, such as measurements of blood pressure and heart rate, provide incomplete information about cardiac function during surgery. Invasive monitoring like intraoperative pulmonary artery pressure measurement with flow-directed balloon catheters may be more sensitive to detect cardiac instability, but they are associated with potentially fatal complications such as dysrhythmias and pulmonary artery rupture. In search of a more informative and yet safe intraoperative hemodynamic monitoring system, we have investigated the use of 2-D transoesophageal echocardiography (TEE). So far more than 400 patients were studied by TEE for up to 12 hours during elective surgery without any complications. High quality recordings of the left ventricle (LV) could be obtained in 87% of all patients. On the basis of the results presented below, we believe that TEE holds three fundamental advantages over the existing monitoring systems: it is inherently safer than intravascular measures, it allows direct assessment of LV filing, and it provides direct information on global and regional LV wall motion.