[Usefulness of transesophageal echocardiography to evaluate the completeness of pediatric patent ductus arteriosus ligation].

Transesophageal echocardiography (TEE) is being utilized with increasing frequency in the operating room both as a monitor and as a diagnostic tool, and its usefulness for determining the adequacy of congenital heart disease repair intraoperatively and postoperatively has been addressed previously. This report describes TEE monitoring in a 4-month-old baby undergoing patent ductus arteriosus (PDA) re-operation. After application of a first double ligation to the ductus via thoracotomy, several investigations in intensive care unit including chest X-ray, transthoracic echocardiography and TEE, detected incomplete ligation, and reoperation was scheduled immediately. Re-operation, a clipping to the ductus, was successfully performed under real-time TEE monitoring. We conclude that the use of intraoperative TEE monitoring during a PDA ligation enables us to avoid residual ductal flows.