Perioperative echocardiography
Perioperative echocardiography is one of the fastest growing areas of echocardiography. Transthoracic imaging is increasingly being used in postoperative patients, in critical care settings, and in emergency medicine. Intraoperative imaging remains the exclusive domain of transoesophageal echocardiography (TOE) where cardiac surgery is the primary field of application. However, the use of intraoperative TOE is gradually expanding towards non-cardiac surgery. The indications for perioperative echo have recently been re-evaluated, resulting in recognition of the ubiquitous benefit in patients undergoing surgery. Although TOE is safe, there may be a greater risk of traumatic damage to the soft tissues in anaesthetized patients who cannot complain of pain nor resist during probe insertion. Perioperative imaging in cardiac surgery should be used to confirm and refine the preoperative diagnosis, detect new or unsuspected pathology, adjust the anaesthetic and surgical plan, and assess the results of surgical intervention. Using imaging to optimize myocardial function is a constantly developing technique to ensure that patients leave the operating room in the best possible condition.