We routinely get a TEE (transesophageal echocardiogram) before surgery and in the operating room both before and after mitral valve repair. We also use advanced 3D imaging to understand what is wrong with the valve. Maybe because my military background, I feel that the more I know about a patient before we go into the operating room, the less chance of a surprise in the operating room and greater chance of a good result. The TEE is an essential part of valve surgery.