The right ventricular systolic pressure (RVSP) is calculated using the modified Bernoulli equation RVSP = 4 x (MaxTRvelocity)2 + RAP. Maximal TR velocity is measured using continuous wave (CW) Doppler. Windows used to measure the maximal TR velocity are the ME 4 chamber view, the ME RV inflow-outflow view and the ME modified bicaval view. TR signal quality is classified in every window according to envelope visibility as good (complete envelope), moderate (partial envelope but prone to extrapolation) or poor (unreliable envelope or no signal). TR severity is assessed as absent, mild, moderate or severe according to the American Society of Echocardiography guidelines. Therefore we measure the paramenters vena contracta, PISA and hepatic venous flow. A predefined value of RVSP > 40mmHg or mean PAP > 25mmHg is considered elevated. We also measure TAPSE, RV Tei Index and LV eccentric index for assessment of pulmonary hypertension. During the whole TEE examination the examiner will be blinded to the pulmonary artery pressure measured by the pulmonary artery catheter. This will be done by a patch that covers just the pulmonary artery measurement on the OR monitor during the TEE examination. After the examination is done the patch will be removed. A study nurse writes down all hemodynamic measurements during the TEE examination.