Transoesophageal echocardiography in cardiac anaesthesia

Echocardiography is the most widely used minimally invasive investigation to diagnose heart disease. Transoesophageal echocardiography (TOE) was first introduced perioperatively in the 1980s and is now an important monitoring tool for patients undergoing cardiac surgery. Because of the close proximity of the oesophagus to the heart, TOE facilitates the acquisition of high-resolution images. The TOE probe is a multiplane transducer. This means that the image planes can be rotated from 0° to 180°, enabling three-dimensional assessment of the structure of interest. Intraoperative TOE has been shown to improve outcome in mitral valve surgery and is frequently used by the surgeon as an aid in deciding whether to repair or replace the valve. TOE has become an important investigation in the assessment of haemodynamic instability in the perioperative period because it allows rapid and accurate diagnosis.