Adult perioperative echocardiography: anatomy, mechanisms and effective communication.

Intra-operative transesophageal echocardiography (TEE) is a mature imaging technique which represents the premier surgical quality control instrument in the contemporary operating room. In adult cardiac surgery, management of valvular heart disease and related structural cardiac abnormalities derive the most benefit from perioperative echocardiography which includes pre-operative transthoracic echocardiography, intra-operative TEE and post-surgical echocardiographic surveillance. This review discusses the theoretical background upon which these imaging techniques are built-on, and offers a practical state-of-the-art guide on their application, emphasizing the importance of anatomic relationships, mechanisms of dysfunction and effective communication with our surgeons.