ABSTRACT
Transesophageal echocardiography (TEE) is an invaluable tool, in the perioperative setting, in patients with inadequate transthoracic echocardiographic (TTE) images and in ventilated critically ill patients (1). Among its multiple intraoperative applications, TEE can be used to monitor global and regional ventricular function as well as the patient’s volume status. The development of new ultrasound technology has permitted better identification and quantitative assessment of ventricular regional wall motion. This chapter focuses on the perioperative TEE evaluation of segmental ventricular function and detection of complications after myocardial infarction.
Coronary anatomy varies but there is an overall pattern of coronary artery distribution. The left main coronary artery rises from the superior aspect of the left sinus of Valsalva and divides into the left anterior descending (LAD) and circumflex coronary arteries (Fig. 9.1). The LAD artery descends in the anterior interventricular groove down to the left ventricular (LV) apex contributing diagonal and septal branches. The circumflex artery continues, laterally, down the left atrioventricular groove giving rise to obtuse marginal branches (Fig. 9.2). The right coronary artery (RCA) rises from the superior aspect of the right sinus of Valsalva and extends inferomedially along the right atrioventricular groove (Fig. 9.3).
