Endoscopic Evaluation of the Esophagus in Infants and Children Immediately Following Intraoperative Use of Transesophageal Echocardiography

Transesophageal Echocardiography in Critically Ill Acute Postoperative Infants: Comparison of AcuNav Intracardiac Echocardiographic and microTEE Miniaturized Transducers

“…The utility, limitations, 1-12 and complications [13][14][15][16][17][18][19][20][21][22] of standard equipment and protocols 23,24 for transesophageal echocardiography (TEE) in patients with congenital heart disease have been well established. However, there remains a subset of the small and most critically ill infants in whom TEE is performed with either an intracardiac transducer or a miniaturized transesophageal transducer.…”

Transesophageal Echocardiography

“…Additional caution must be exercised when inserting the probe in dogs that weigh less than 5 kg. Studies have shown that TEE can be performed without risk in children and in small anticoagulated animals with an intact mucosa or minimal injuries [12,13], especially if the examinations are performed with appropriate training and caution. The authors have never observed any signs of esophageal trauma in performing 200 examinations.…”

Transesophageal echocardiography-related complications

“…Endoscopic evaluation of the esophagus completed on children between four months and ten years of age immediately following intraoperative TEE disclosed abnormalities in 64% of the patients. 69 Abnormalities encountered included erythema (54%), edema (24%), hematoma (22%), mucosal erosion (14%), and petechiae (4%). Also, mild mucosal injury was documented more frequently in patients weighing less than 9 kg.…”

“…97 It has been reported that large intrathoracic pressures and hemodynamic changes resulting from retching have produced fatal pulmonary embolization from a right atrial mass, 98,99 embolization of mitral vegetation and a left intracardiac thrombus resulting in stroke, 40,100 a myxoma embolus, 99 and progressive aortic dissection and cardiac tamponade. 101 Pediatric patients may be more vulnerable to TEE, in that the esophageal probe can significantly compress vascular structures 69 such as a normally positioned 34 or aberrant right subclavian artery, 102,103 the descending aorta, 104,105 the innominate artery, 106 and the pulmonary venous confluence in an infant with total anomalous pulmonary venous return. [107][108][109] The hemodynamic effect of the TEE on cerebral perfusion pressure must also be reduced, especially in the presence of elevated intracranial pressure.…”