Inclusion Criteria:  Cardiac surgery or surgery on the vessels near the heart  Exclusion Criteria:  Pregnant patients Unfeasibility of intraoperative echocardiography in contraindications to transesophageal echocardiography: esophageal carcinoma, varices, diverticula, strictures, acute esophagitis, previous esophageal or gastric bleeding, symptomatic hiatal hernia. No written consent obtainable.