Transoesophageal echocardiographic monitoring during paediatric cardiac surgery: obtainable information and feasibility in 532 children

Abstract

These data stress the safety and ease of performing TOE in children undergoing cardiac surgery. There is evidence for benefit from TOE findings to potentially enhance the therapeutic basis.

Transesophageal Echocardiography

“…Most would agree that the individual performing intraoperative TEE should meet established experience and training guidelines for pediatric TEE [30,73,74]. Although most examinations are performed by cardiologists, a number of pediatric cardiac anesthesiologists have been important contributors, advocates and performers of intraoperative pediatric TEE [75][76][77][78]. Sloth et al reported a series of 532 children in whom intraoperative TEE examinations were performed by anesthesiologists [75].…”

“…Although most examinations are performed by cardiologists, a number of pediatric cardiac anesthesiologists have been important contributors, advocates and performers of intraoperative pediatric TEE [75][76][77][78]. Sloth et al reported a series of 532 children in whom intraoperative TEE examinations were performed by anesthesiologists [75]. There was but a single complication, one extubation.…”

“…The final decision of whether to return to bypass is one made by the surgeon, upon consideration of the full information available from the intraoperative team. TEE has been reported to identify problems needing a return to bypass for further surgery in about 3-8% of bypass cases [6][7][8]12,13,17,18,20,21,[23][24][25]27,[66][67][68][69][70]75,94,99,101,110,118,119]. With a return to bypass rate in this range, the routine use of TEE during repair of congenital heart malformations is cost-effective [82,83,100,101,120,121].…”

Occlusion of the right subclavian artery after insertion of a transoesophageal echocardiography probe in a neonate

“…Transoesophageal echocardiography (TOE) has become a reliable intraoperative technique for assessing cardiac structure and function in infants and children with congenital heart disease undergoing cardiac surgery (1–3). Despite the widespread use of TOE.…”

Intra-operative trans-esophageal echocardiography in congenital heart disease

“…Various studies have shown the impact of TEE on patients undergoing surgery for congenital heart disease. [4][5][6][7][8][9][10][11][12][13] Gallivan, et al [14] classified patients into three categories depending on surgical risk as an indication for performing intra-operative TEE: 1) Low risk; e.g., atrial septal defect (ASD), ventricular septal defect (VSD), valve replacement, and extracardiac procedures. 2) Moderate risk; e.g., atrioventricular (AV) I n t r a -o p e r a t i v e t r a n s -e s o p h a g e a l echocardiography (TEE) is an important monitoring and diagnostic tool used during surgery for repair of congenital heart disease.…”