What intraoperative monitoring would be appropriate?

What intraoperative monitoring would be appropriate?

An intra-arterial catheter and pulmonary artery catheter (PAC) are clearly indicated in this patient and should be placed before the induction of anesthesia. The benefits of a PAC include the ability to gather information on left atrial filling pressure, pulmonary artery pressure, cardiac output, and pulmonary and systemic vascular resistances. Knowledge of pulmonary artery pressures is particularly important in the presence of RV dysfunction because successful therapy includes manipulations of RV afterload.

Transesophageal echocardiography (TEE) also provides the opportunity to observe biventricular function, left atrial dimensions, and valvular function. TEE offers informa-tion on left ventricular filling, left ventricular contractility, RV function, interventricular septal shift and, following cardiopulmonary bypass, on the function of the repaired valve or the prosthetic valve.