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The role of transesophageal echocardiography in the diagnosis and management of children and young adults with valvar diseases of the left heart

Published online by Cambridge University Press:  19 August 2008

Maurice P. Leung ,
Tak-Cheung Yung ,
Bobby Chan ,
Clement Chiu ,
Jan Lee  and
Che-Kueng Mok
Maurice P. Leung*
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Tak-Cheung Yung
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Bobby Chan
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Clement Chiu
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Jan Lee
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Che-Kueng Mok
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
*
Dr. Maurice P. Leung, Paediatric Cardiological Division, University of Hong Kong, Grantham Hospital, 125 Wong Chuk Hang Road, Aberdeen, Hong Kong. Tel. (852) 554-6471 Ext. 249; Fax. (852) 554-2011.
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Summary

The role of transesophageal echocardiography in the diagnosis and management of left-sided cardiac valvar disease in children and young adults was assessed in terms of whether additional information (over transthoracic echocardiography) could be obtained, and whether the added information contributed to the better management of the patients. Between January 1991 to August 1992, 27 consecutive patients were studied. Their age ranged from 2.5 to20 years (mean 12.7), with body weights ranging between 12 and 60 kg (mean 35.6). Twelve of the children suffered from atrioventricular valvar disease, 13 had predominant aortic valvar lesions and two had mixed valvar pathologies. Additional information was obtained by transesophageal over that of transthoracic echocardiography in 18 children (67%). Transesophageal echocardiography clarified the etiologies or mechanism of valvar regurgitation in eight and seven children with atrioventricular and aortic pathologies, respectively. The technique correctly diagnosed severe mitral regurgitation underestimated by conventional technique, detected a missed eccentric aortic regurgitant jet and convincingly excluded bacterial vegetations in one case each. The investigation contributed to the better management of three children (11%) by providing information that allowed the appropriate choice of therapy. Transesophageal echocardiography, therefore, is a useful technique for the diagnosis and management of valvar disease of the left heart in children and young adults.

Keywords

Transesophageal echocardiographymitral valveaortic valve
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 4 , October 1994 , pp. 373 - 380
Copyright
Copyright © Cambridge University Press 1994

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