Transesophageal echocardiography (TEE) plays an important role in intraoperative monitoring and can be used to estimate pulmonary artery pressures. In 1984 Yock et al. were the first ones who reported an excellent correlation between right ventricular systolic pressure (RVSP) measured by right heart catheterization (RHC) and simultaneously estimated by transthoracic echocardiography. Later this was confirmed by several authors (3-6) and therefore also implemented into the current guidelines for the echocardiographic assessment of the right heart in adults by the American Society of Echocardiography. So far there are no studies evaluating RVSP measured by transesophageal echocardiography (TEE) and recommendations are unclear which transesophageal view is the best for calculation. More recent studies evaluated the accuracy of echocardiography in patients with pulmonary hypertension and mostly revealed only a moderate to weak correlation between echocardiography and right heart catheter mesurements. One study evaluated patients with severe tricuspid regurgitation and pulmonary hypertension and showed that pulmonary artery systolic pressure is frequently overestimated in this population. Fewer studies reported a good correlation between these two methods. There is also evidence that additional indices and paramenters can help to assess pulmonry hypertension more precisely with echocardiography, such as TAPSE, Tei index or LV eccentric index. These parameters seem to be abnormal in presence of pulmonary hypertension.