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

Hascoët, Sébastien; Peyre, Marianne; Hadeed, Khaled; Alacoque, Xavier; Chausseray, G.; Fesseau, Rose; Amadieu, Romain; Léobon, Bertrand; Berthomieu, Lionel; Dulac, Yves; Acar, Philippe

doi:10.1016/j.acvd.2014.05.001

Cited by 18 publications

(8 citation statements)

References 24 publications

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“…Rather, we aimed to convey that it is the standardization of the approach, and following of a protocol, that increases rates of visualization. With the development of the miniaturized transducers, which can be used in small neonates, and further advances in in technology, it may be that transesophageal echocardiography becomes preferable to e‐echo. However, demonstration of adequate visualization of the vascular anatomy would need to be shown.…”

Section: Discussionmentioning

confidence: 99%

Utility of a standardized postcardiopulmonary bypass epicardial echocardiography protocol for stage I Norwood palliation

Stern

Emani

Geva

2017

Congenital Heart Disease

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Objective Stage 1 Norwood palliation is one of the highest risk procedures in congenital cardiac surgery. Patients with superior technical performance scores have more favorable outcomes. Intraoperative epicardial echocardiography may allow the surgeon to address residual lesions prior to leaving the operating room, resulting in improved technical performance. The ability of intraoperative epicardial echocardiography to visualize the relevant anatomy and its association with outcomes is not known. Design A standardized intraoperative epicardial echocardiography protocol was developed and performed at the conclusion of Stage 1 Norwood palliation. Data pertaining to visualization of relevant anatomy, and comparison of intraoperative echocardiogram findings with other post-operative investigations was performed. Clinical outcomes, including technical performance, were collected. A historical cohort who received either no echocardiogram or a non-standardized examination was used as a comparison group. Results Thirty on-protocol and 30 pre-protocol patients, 22 of whom had a non-standardized intraoperative epicardial echocardiogram, were studied. Compared with pre-protocol, visualization of the relevant anatomy was significantly increased for the Damus-Kaye-Stansel anastomoses (93% vs. 68% P=0.03) and branch pulmonary arteries (70% vs. 36%, P=0.02). One residual lesion requiring immediate operative reintervention was diagnosed in the pre-protocol group. There were 5 patients in each cohort with residual lesions during the post-operative hospitalization that were not appreciated on the intraoperative echocardiogram. Technical performance, rates of reintervention and clinical outcomes were not significantly different between the two groups. Conclusions Intraoperative epicardial echocardiography is technically feasible and increases visualization of the relevant anatomy. Larger investigations may be warranted to determine if there is clinical benefit to such an approach.

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Section: Discussionmentioning

confidence: 99%

Utility of a standardized postcardiopulmonary bypass epicardial echocardiography protocol for stage I Norwood palliation

Stern

Emani

Geva

2017

Congenital Heart Disease

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“…After NP, as well as ongoing assessment of the RV and valvar function, the operated areas must be interrogated for signs of function. Many patients may have epicardial (16) or transesophageal echocardiography (17,18) in the operating theater, and if there are concerns either on the echocardiogram of with the patients' hemodynamics, then there should be a low threshold for diagnostic angiography ± intervention. For example in the patient with unexplained desaturation coming off bypass despite maximal oxygen therapy.…”

Section: Imaging After Norwood Proceduresmentioning

confidence: 99%

Noninvasive Imaging in Interventional Cardiology: Hypoplastic Left Heart Syndrome

Bellsham‐Revell

2021

Front. Cardiovasc. Med.

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Hypoplastic left heart syndrome (HLHS) is a spectrum of left heart underdevelopment leaving the left side unable to support the systemic circulation. If active management is pursued, then the condition is managed with staged palliation to the Fontan circulation, leaving a systemic right ventricle. Through all surgical stages, and even after completion of Fontan, there are multiple areas that may require intervention, most frequently the branch pulmonary arteries which are essential to a successful Fontan circulation. Echocardiography is the mainstay of assessment, but there is an increasing use of magnetic resonance imaging (MRI) and computed tomography (CT) particularly in relation to extracardiac structures which can be more challenging with echocardiography. Both MRI and CT require set-up, experience and training, and usually sedation or anesthetic in smaller children, but can provide excellent imaging to guide interventions. Cardiac MRI is also able to quantify right ventricular (RV) function which can be challenging on echocardiography. This article describes the modalities available and their use in assessing patients with HLHS prior to catheter interventions.

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“…Image quality and safety profile are good, even with the miniaturized transducer (Philips S8-3t micro), which can be used in infants as small as 2.5 kg. [15][16][17][18] Other advantages include allowing the surgeon to focus on the procedure, rather than be distracted by obtaining images themselves.…”

Section: Epicardial Versus Transesophageal Imagingmentioning

confidence: 99%

Epicardial Echocardiography in Pediatric and Congenital Heart Surgery

Stern

Emani

Peek

et al. 2019

World J Pediatr Congenit Heart Surg

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Epicardial echocardiography (e-echo) is a useful approach to intraoperative imaging for the smallest patients and in those with contraindications to transesophageal echocardiography (TEE). The e-echo has additional advantages that include improved visualization of anterior and vascular structures and three-dimensional capabilities. In this review, we describe the advantages and disadvantages of e-echo versus TEE for pediatric and congenital heart surgery with the goal of enhancing the utility and feasibility of the former among congenital heart surgeons. We also review the technique for performance of an e-echo and provide demonstrations of the images obtained for select lesions.

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

Abstract: Micro-multiplane TOE is safe and efficient for use in neonates and children. This minimally invasive tool increases the impact of TOE in paediatric cardiology.

Cited by 18 publications

References 24 publications

Utility of a standardized postcardiopulmonary bypass epicardial echocardiography protocol for stage I Norwood palliation

Utility of a standardized postcardiopulmonary bypass epicardial echocardiography protocol for stage I Norwood palliation

Noninvasive Imaging in Interventional Cardiology: Hypoplastic Left Heart Syndrome

Epicardial Echocardiography in Pediatric and Congenital Heart Surgery

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