What are the common intraoperative monitors for myocardial ischemia?
The most common monitor of intraoperative ischemia is electrocardiography. At least two leads should be moni-tored in order to diagnose more than 95% of ischemic episodes. The pulmonary artery catheter can also be used to diagnose ischemia when the PCWP or the pulmonary artery diastolic pressure increases. This can also be referred to as a “v wave” of the PCWP tracing. The PCWP is not as sensitive as the electrocardiogram for detecting ischemia. The most sensitive monitor for ischemia is TEE, in which regional wall motion abnormalities occur very early in the course of reduced coronary perfusion. TEE is probably too sensitive; PCWP is probably not sensitive enough; thereby leaving electrocardiography as the most accurate monitor of coronary ischemia.