Transesophageal echocardiography as an intraoperative monitor

Echocardiography is recognized as a excellent diagnostic tool for non-invasive cardiac assessment. Recently, transesophageal echocardiography has been utilized as an "on line, real time" intraoperative monitoring device in cases where patients are at significant risk for intraoperative cardiac ischemia, large shifts in hemodynamic parameters, and/or air embolism. This advancement in cardiac and hemodynamic intraoperative monitoring is significant as it enables early recognition of cardiac ischemia through assessment of cardiac contractility and regional wall motion abnormalities; accurate volume status assessment with direct monitoring of cardiac chamber volumes, valvular function, and intracardiac shunting; and real time assessment of the presence, size, and location of intracardiac air. Transesophageal echocardiography is a safe and accurate tool enabling early recognition of those physiological intraoperative changes where early intervention is critical for improved patient outcome.