JACC Vol. 16. No. 2

433

Aogast 1990:433-at

PEDIATRIC

CARDIOLOGY

Transesophageal Echocardiography in Children With Congenital Heart Disease: An Initial Experience OLIVER F . W. STUMPER, MD, ';'rNKE J . ELZENGA, MD. JOHN HESS, MD, GEORGE R . SUTHERLAND, FRCP Rotterdam, The Netheriands

Transesophageal echocardiography with a single plane (transverse axis), dedicated pediatric probe was performed prospectively in 25 anesthetized children undergoing row due cardiac catheterization or intracardiac surgery, to assess the potential role of this technique In the initial diagnosis, perioperative management and postoperative follow-up of children with congenital heart disease . The group ranged in age from 1 year to 14.8 years (mean 6 .1) and weight from 5.5 to 52 kg (mean 22,4) . Studies were successful in all patients and no complications went encoun. The results of the traiwesophageal studies (combined tered Imaging, color flow mapping and pulsed wave Doppler sampling) were correlated both with the results of prior precordial studies and the information obtained at cardiac catheterlzation. Tranaesophageal echocardiography provided a more

Since the introduction of high resolution tran ;esophageal echocardiographic imaging combined with colo- flow mapping in cardiologic practice some 3 years ago, it has gained widespread acceptance both as a diagnostic technique with specific applications in the adult outpatient clinic and as a perioperatve monitoring technique in cardiac surgery (1-4) . Although experience with this new semi-invasive technique in the adult cardiac patient group has rapidly expanded over recent years, its use in the pediatric cardiac patient group is still very limited (5,6). The reasons for this are multifold . First, all standard adult transesophageal probes exceed 12 mm in maximal diameter and thus are too large for safe use in small children . Second, tolerance of transesophageal

From the Department of Echncardiegraphy . Thomacenter and Sophia Children's Hospital, Emsmus University. Rotterdam, The Nelherland,. Dr . stamper was, supported by the Deutsche Forschungsgemeinschaft, Bonn, Federal Republic of Gomlmy . Manuscript received September 22, 1989; revised manuscript received December 23, 1989, accepted March 13, 1990 . Address r mpdan; George R . Sutherland, FRCP, Department of Eohocardiogrephy, RA 300, Thuwxcenter. Cosmos University Rotterdam . PD Box 1738, 3000 DR Rotterdam, The Netherlands. ®1990 by the American College of Cardiology

detailed evaluation of the morphology and function of systemic and pulmonary ve~tous return, the atria, interatrial baffles, atrfoventricular valves and the kit ventriew tar outflow tract . Additional tuformatioo was obtained in 1S patients (60%). Problem areas for single plane traausophageol imaging were the apical interventrieular septum, the right ventricular outflow trod and the left pulmonary artery . The intraoperative am of transeseplagwt echocar . Biography allowed assessment of The surgical repair and monitoring of ventricular function and volume status white the patient was weaned from cardlopulmooary bypsa . Transesophagoal echocardiography in pediatric patients is of additional value in three main areas: 1) the precise morphologic diagnosis of congenital heart disease, 2) perioperative monitoring, and 3) postsurgical follow-up . (J Am Call Cannot 1990;16.:433-41)

investigations is poor in older children even under sedation and should not be attempted in children

Transesophageal echocardiography in children with congenital heart disease: an initial experience.

Transesophageal echocardiography with a single plane (transverse axis), dedicated pediatric probe was performed prospectively in 25 anesthetized child...
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