3 Monitoring of left ventricular systolic function

Transoesophageal echocardiography has gained the role of a standard monitoring technique for both cardiac surgical patients and patients with increased cardiac risk under-going non-cardiac surgery. It offers unique information about left ventricular global and regional performance on a ‘beat-to-beat’ basis without subjecting the patient to a major degree of invasiveness. In addition to the fact that considerable experience is required to obtain reliably (and to maintain) the standard monitoring view of the left ventricle and to identify correctly the cardiac structures of interest, there are some other limitations inherent to the method that have to be recognized in order to obtain reliable results. In particular, the fact that with recent technological advances, such as acoustic quantification, on-line display of various left ventricular function parameters is provided which could blind us to possible sources of error. This and future technological developments should be used to their full potential but any pseudoaccuracy must not be overlooked.