Transoesophageal echocardiographic monitoring of left ventricular function.

Technical advances in echocardiography, especially the introduction of oesophageal probes, have led to the extension of its indications to the field of anaesthesia and intensive care. Transoesophageal echocardiography (TEE) provides high quality imaging of the left ventricle in patients on ventilators. In addition, manipulation of the probe is performed near the patient's head and so does not interfere with the surgeon's job. This enables echocardiographic monitoring of left ventricular function throughout the operation. The information so obtained not only provides data about anatomical changes which is sometimes invaluable, but also allows quantification of left ventricular function which is the main advantage for anaesthetists. The images allow study of regional and global left ventricular contraction and the deduction of certain parameters of ventricular performance. The ability to perform real time monitoring of ventricular function throughout anaesthesia and the immediate postoperative period is all the more valuable in patients with limited cardiac and coronary reserve. This new method of monitoring gives a better understanding of the physiopathology of peroperative cardiac events and provides information which may guide the conduct of the anaesthesia and postoperative care.