Isolated left ventricular noncompaction (LVNC) is a rare primary genetic 
cardiomyopathy characterized by prominent trabeculation of the left ventricular 
wall and intertrabecular recesses. Perioperative management of the patient with 
LVNC might be challenging due to the clinical symptoms of heart failure, 
systemic thromboembolic events, and fatal left ventricular arrhythmias. We 
conducted real time intraoperative transesophageal echocardiography in a patient 
with LVNC undergoing general anesthesia for ovarian cystectomy.