Intraoperative Transesophageal Echocardiography in a 1.4-kg Infant with Complex Congenital Heart Disease

Abstract

The lower weight limit for infants undergoing intraoperative transesophageal echocardiography (TEE) with current commercially available probes has not been determined. A review of the literature reveals that infants as small as 1.6 kg have been studied successfully. This report describes the first intraoperative TEE reported in a 1.4-kg infant during truncus arteriosus/interrupted aortic arch repair. Successful pre- and postoperative images of the cardiac abnormality were obtained. Probe insertion was performed in this small patient after predilating the esophagus with a 14-F suction catheter.

Transesophageal Echocardiography Probe Insertion Failure in Infants Undergoing Cardiac Surgery

“…reviewed their experience with iTEE in 314 patients and reported a weight less than 4 kg as a risk factor for failure to pass the TEE probe . Only isolated case reports have previously documented successful iTEE probe insertion in infants less than 2 kg . In this study, 21 subjects weighed less than 2 kg of whom four patients (19%) underwent successful iTEE probe insertion.…”

“…Institutions may be hesitant to insert transesophageal echocardiography (TEE) probes in very small infants because of potential risks associated with probe insertion, most importantly esophageal injury or perforation and ventilatory and/or hemodynamic compromise . There have been only isolated case reports documenting successful insertion of the TEE probe in very small infants …”

“…6,7 There have been only isolated case reports documenting successful insertion of the TEE probe in very small infants. [8][9][10] To date, no study has systematically described the use of iTEE and identified risk factors for probe insertion failure in very small infants undergoing cardiac surgery. We sought to identify the prevalence of iTEE probe insertion failure and to determine risk factors for probe insertion failure in infants Յ4 kg.…”

Intravascular ultrasound catheter for transesophageal echocardiography in congenital heart surgery -A case report-

“…Mart et al [7] reported successful TEE evaluation in a 1.4 kg infant with complex congenital heart disease. They dilated the esophagus prior to inserting the TEE probe.…”

Prediction of Early Pulmonary Artery Stenosis after Arterial Switch Operation: The Role of Intraoperative Transesophageal Echocardiography

“…There are several reports demonstrating that TEE can be used safely in very-low-birth weight newborns undergoing cardiac operations [22, 23]. However, the application of TEE to detect and predict development of neo-PS in small infants undergoing ASO has not been reported before now.…”