In recent years, the perioperative use of transesophageal echocardiography has expanded dramatically. The major reasons for this rapid expansion are first, the development of echocardiographic equipmnt that provides high-quality information; second, the greater mobility of echocardiographic equipment; third, a growing body of evidence indicating that perioperative echocardiographic information does influence patient outcomes; and fourth, an increasing number of anesthetists and intensivists with advanced echocardiographic skills.