Predictive Value of Intraoperative Diagnosis of Residual Ventricular Septal Defects by Transesophageal Echocardiography

Hanna, Baher; Elhewala, Ahmed; Gruber, Peter J.; Gaynor, J. William; Spray, Thomas L.; Seliem, Mohamed

doi:10.1016/j.athoracsur.2009.10.058

Cited by 26 publications

(19 citation statements)

References 11 publications

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“…Given the potential confounding factors outlined above, it is possible that the accuracy is even higher. This compares favorably with intra operative transesophageal echocardiography (an established method for detection of residual shunts), where a study of 573 post cardiac surgical patients yielded a sensitivity and specificity of 58 and 57 % respectively versus transthoracic echocardiography [1].…”

Section: Discussionmentioning

confidence: 94%

“…The limitations of transthoracic echocardiography in the immediate post-operative period are well documented, where intracardiac shunt detection can be influenced by many factors including the quality of windows post thoracotomy, type of operative repair and rapidly changing hemodynamics [1][2][3][4]. In addition, we did not investigate the false positive cases (shunt detected by UD only) for the presence of extra cardiac shunts, which are common with some cardiac lesions [28,29].…”

Section: Discussionmentioning

confidence: 95%

“…This phenomenon has been investigated predominantly following corrective cardiac surgery for congenital heart disease, where the incidence of echocardiographically diagnosed residual shunt may be in the range of 33-38 % for certain lesions [1][2][3][4]. However, the accuracy of shunt identification may vary according to the timing of imaging (relative to surgery), and the echocardiographic modality used [3].…”

Section: Introductionmentioning

confidence: 97%

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Accuracy of the transpulmonary ultrasound dilution method for detection of small anatomic shunts

Saxena

Krivitski

Peacock

et al. 2014

J Clin Monit Comput

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The purpose of this study was to investigate the qualitative and quantitative accuracy of transpulmonary ultrasound dilution (UD) (COstatus™, Transonic Systems) for the detection of small anatomic shunts. It was a prospective, observational study in a multi-disciplinary pediatric intensive care unit. Seventy-three critically ill children (67 post cardiac surgery), with a median (IQR) age of 10 (3-50.3) months and a median (IQR) weight of 8 (3.43-13) kg were enrolled. Ultrasound dilution (UD) measurements were performed on patients within 1 h of undergoing two-dimensional echocardiography, which was used as the comparator technique. Shunt was diagnosed by characteristic changes on the UD curve shape, and was considered "test-positive" only if two or more measurements suggested the presence of the shunt. The UD technology also provided an estimate of pulmonary to systemic blood flow ratio (Qp:Qs). 12/73 (16.4 %) patients had a shunt identified by both UD and echocardiography. The overall accuracy (95 % CI) was 86.1 % (75.6-96.6 %), with a sensitivity of 85.7 % (57.2-98.2 %) and specificity of 86.4 % (75.0-94.0 %). The estimated Qp:Qs ranged from 0.7 to 1.4, which was consistent qualitatively with the echocardiographic findings on color flow doppler. Shunt was detected by UD alone in eight children; six of these had clinical conditions known to compromise dilution curve analysis (valve regurgitation, asymmetric pulmonary blood flow). Shunt was detected by echocardiography alone in two children; in both cases the shunt was tiny. UD is an accurate method for the detection of small anatomical shunts, both qualitatively and quantitatively.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 97%

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Accuracy of the transpulmonary ultrasound dilution method for detection of small anatomic shunts

Saxena

Krivitski

Peacock

et al. 2014

J Clin Monit Comput

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“…The sensitivity of TOE to detect residual ventricular septal defect is good [18,19]. In tetralogy of Fallot repair, intraoperative echocardiography helps in differentiating 'fixed' from 'dynamic' obstruction and helps obviate needless revisions [20].…”

Section: Discussionmentioning

confidence: 98%

Safety and efficiency of the new micro-multiplane transoesophageal probe in paediatric cardiology

Hascoët¹,

Peyre²,

Hadeed³

et al. 2014

Archives of Cardiovascular Diseases

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“…Real time (RT) 3D TEE can accurately assess location, attachment and size of intracardiac masses as atrial and ventricular septal defects, simplifying surgical planning [10][11][12]. Myxomas are the most common cardiac tumors and may arise in any of the four cardiac chambers, usually in the left atrium (LA).…”

Section: Cardiac Surgerymentioning

confidence: 99%

Intraoperative Transesophageal Echocardiography: Review and Evolution

Duque¹,

Machado²

2016

General Anesthesia and Sleep

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Predictive Value of Intraoperative Diagnosis of Residual Ventricular Septal Defects by Transesophageal Echocardiography

Cited by 26 publications

References 11 publications

Accuracy of the transpulmonary ultrasound dilution method for detection of small anatomic shunts

Accuracy of the transpulmonary ultrasound dilution method for detection of small anatomic shunts

Safety and efficiency of the new micro-multiplane transoesophageal probe in paediatric cardiology

Intraoperative Transesophageal Echocardiography: Review and Evolution

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