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Transoesophageal echocardiography in monitoring, guiding, and evaluating surgical repair of congenital cardiac malformations in children

Published online by Cambridge University Press:  20 April 2007

Xiao-Jing Ma ,
Guo-Ying Huang ,
Xue-Cun Liang ,
Zhang-Gen Chen ,
Bing Jia ,
Xin Li  and
Ming Ye
Xiao-Jing Ma
Affiliation:
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China
Guo-Ying Huang
Affiliation:
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China
Xue-Cun Liang
Affiliation:
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China
Zhang-Gen Chen
Affiliation:
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China
Bing Jia
Affiliation:
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China
Xin Li
Affiliation:
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China
Ming Ye
Affiliation:
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China
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Abstract

Objective: To evaluate the role of transoesophageal echocardiography and problems related to safety during the surgical repair of congenital cardiac malformations in children. Methods: We examined the transoesophageal recordings made in 350 children with congenital cardiac diseases, aged from 2 months to 17 years and 9 months, with a median age of 2.7 years, tracings having been taken both before and after cardiopulmonary bypass. All patients had been scanned by transthoracic echocardiography before the operative procedures. Results: Preoperative transoesophageal echocardiography added additional findings, or changed the diagnoses made using transthoracic echocardiography, in 33 cases (9.4%), among which the findings had therapeutic significance in 23 cases (6.6%) that altered the planned surgical procedures. Residual problems or sequels were detected by postoperative transoesophageal echocardiography in 57 cases (16.3%), with 13 patients (3.7%) requiring instant intervention or return to bypass for modifications of the surgical procedures. We encountered no severe complications due to the performance of transoesophageal echocardiography. Mild complications occurred in only 2 patients (0.6%). Conclusions: Transoesophageal echocardiography is a useful tool with which to determine the strategies for treatment in the perioperative period, and to improve the quality of surgical procedures in children with congenital cardiac diseases. Complications were few, but still deserved careful attention to detail.

Keywords

Congenital heart diseaseperioperative periodpaediatrics
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 3 , June 2007 , pp. 301 - 306
Copyright
© 2007 Cambridge University Press

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References

Sloth E, Pedersen J, Olsen KH, Wanscher M, Hansen OK, Sorensen KE. Transoesophageal echocardiographic monitoring during paediatric cardiac surgery: obtainable information and feasibility in 532 children. Paediatr Anaesth 2001; 11: 657–662.Google Scholar
Mochizuki Y, Patel AK, Banerjee A, Patel AR, Pandian NG. Intraoperative transoesophageal echocardiography: correlation of echocardiographic findings and surgical pathology. Cardiol Rev 1999; 7: 270–276.Google Scholar
Randolph GR, Hagler DJ, Connolly HM, et al. Intraoperative transoesophageal echocardiography during surgery for congenital heart defects. J Thorac Cardiovasc Surg 2002; 124: 1176–1182.Google Scholar
Bettex DA, Schmidlin D, Bernath MA, et al. Intraoperative transoesophageal echocardiography in pediatric congenital cardiac surgery: a two-center observational study. Anesth Analg 2003; 97: 1275–1282.Google Scholar
Siwik ES, Spector ML, Patel CR, Zahka KG. Costs and cost-effectiveness of routine transoesophageal echocardiography in congenital heart surgery. Am Heart J 1999; 138: 771–776.Google Scholar
Ayres NA, Miller-Hance W, Fyfe DA, et al. Indications and guidelines for performance of transoesophageal echocardiography in the patient with pediatric acquired or congenital heart disease: A report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2005; 18: 91–98.Google Scholar
Bettex DA, Pretre R, Jenni R, Schmid ER. Cost-effectiveness of routine intraoperative transoesophageal echocardiography in pediatric cardiac surgery: a 10-year experience. Anesth Analg 2005; 100: 1271–1275.Google Scholar
Stevenson JG. Utilization of intraoperative transoesophageal echocardiography during repair of congenital cardiac defects: a survey of North American centers. Clin Cardiol 2003; 26: 132–134.Google Scholar
Ramamoorthy C, Lynn AM, Stevenson JG. Pro: transoesophageal echocardiography should be routinely used during pediatric open cardiac surgery. J Cardiothorac Vasc Anesth 1999; 13: 629–631.Google Scholar
McGowan FX, Laussen PC. Con: transoesophageal echocardiography should not be used routinely for pediatric open cardiac surgery. J Cardiothorac Vasc Anesth 1999; 13: 632–634.Google Scholar
Mazic U, Gavora P, Masura J. The role of transoesophageal echocardiography in transcatheter closure of secundum atrial septal defects by the Amplatzer septal occluder. Am Heart J 2001; 142: 482–488.Google Scholar
Latiff HA, Samion H, Kandhavel G, Aziz BA, Alwi M. The value of transoesophageal echocardiography in transcatheter closure of atrial septal defects in the oval fossa using the Amplatzer septal occluder. Cardiol Young 2001; 11: 201–204.Google Scholar
Milani RV, Lavie CJ, Gilliland YE, Cassidy MM, Bernal JA. Overview of Transoesophageal Echocardiography for the Chest Physician. Chest 2003; 124: 1081–1089.Google Scholar
Ho AC, Chen CK, Yang MW, Chu JJ, Lin PJ. Usefulness of intraoperative transoesophageal echocardiography in the assessment of surgical repair of pediatric ventricular septal defects with video-assisted endoscopic techniques in children. Chang Gung Med J 2004; 27: 646–653.Google Scholar
Rosenfeld HM, Gentles TL, Wernovsky G, et al. Utility of intraoperative transoesophageal echocardiography in the assessment of residual cardiac defects. Pediatr Cardiol 1998; 19: 346–351.Google Scholar
Stevenson JG, Sorensen GK, Gartman DM, Hall DG, Rittenhouse EA. Transoesophageal echocardiography during repair of congenital cardiac defects: identification of residual problems necessitating reoperation. J Am Soc Echocardiogr 1993, 6: 356–365.Google Scholar
Ungerleider RM. Biplane and multiplane transoesophageal echocardiography. Am Heart J 1999; 138: 612–613.Google Scholar
Stevenson JG. Incidence of complications in pediatric transoesophageal echocardiography: experience in 1650 cases. J Am Soc Echocardiogr 1999; 12: 527–532.Google Scholar
Daniel WG, Erbel R, Kasper W, et al. Safety of transoesophageal echocardiography. A multicenter survey of 10,419 examinations. Circulation 1991; 83: 817–821.Google Scholar
Kallmeyer IJ, Collard CD, Fox JA, Body SC, Shernan SK. The safety of intraoperative transoesophageal echocardiography: a case series of 7200 cardiac surgical patients. Anesth Analg 2001; 92: 1126–1130.Google Scholar
Andropoulos DB, Ayres NA, Stayer SA, Bent ST, Campos CJ, Fraser CD. The effect of transoesophageal echocardiography on ventilation in small infants undergoing cardiac surgery. Anesth Analg 2000; 90: 47–49.Google Scholar
Stienlauf S, Witzling M, Herling M, Harpaz D. Unilateral pulmonary edema during transoesophageal echocardiography. J Am Soc Echocardiogr 1998; 11: 491–493.Google Scholar
Sakai T, Terao Y, Miyata S, Hasuo H, Haseba S, Yano K. Postoperative recurrent laryngeal nerve palsy following a transoesophageal echocardiography. Masui 1999; 48: 656–657.Google Scholar
Lennon MJ, Gibbs NM, Weightman WM, Leber J, Ee HC, Yusoff IF. Transoesophageal echocardiography-related gastrointestinal complications in cardiac surgical patients. J Cardiothorac Vasc Anesth 2005; 19: 141–145.Google Scholar
Rousou JA, Tighe DA, Garb JL, et al. Risk of dysphagia after transoesophageal echocardiography during cardiac operations. Ann Thorac Surg 2000; 69: 486–489.Google Scholar
Kohr LM, Dargan M, Hague A, et al. The incidence of dysphagia in children after open heart procedures with transoesophageal echocardiography. Ann Thorac Surg 2003; 76: 1450–1456.Google Scholar
Bensky AS, Brien JJ, Hammon JW. Transoesophageal echo probe compression of an aberrant right subclavian artery. J Am Soc Echocardiogr 1995; 8: 964–966.Google Scholar
Koinig H, Schlemmer M, Keznickl FP. Occlusion of the right subclavian artery after insertion of a transoesophageal echocardiography probe in a neonate. Paediatr Anaesth 2003; 13: 617–619.Google Scholar
Greene MA, Alexander JA, Knauf DG, et al. Endoscopic evaluation of the esophagus in infants and children immediately following intraoperative use of transoesophageal echocardiography. Chest 1999; 116: 1247–1250.Google Scholar