Intraoperative evaluation of micromultiplane transesophageal echocardiographic probe in surgery for congenital heart disease.

INTRODUCTION

In the last years, transesophageal transducers for multiplane Doppler echocardiography have demonstrated their superior imaging performance in pediatric patients undergoing cardiac surgery. To date, the size of these probes has limited their use in neonates and small children. New technologies allowing performing TEE in smaller patients are therefore promising.

METHODS

We report our clinical experience with the Oldelft micromultiplane TEE probe (8.2-7mm diameter tip with a 5.2mm diameter shaft) specifically meant for use in neonates.

RESULTS

Forty-two patients were examined intra-operatively using the micromulti TEE harmonic transducer. Patients examined ranged in age from 4days to 6years and ranged in weight from 2.5 to 23.8kg. In two patients we had to adapt ventilatory settings because of increased airway resistance after probe insertion. In 3 patients surgical re-intervention was performed due to TEE assessment immediately after weaning from bypass. In two patients significant obstruction of the right ventricular outflow tract was still present after Fallot correction, and one patient had an additional muscular ventricular septal defect still present after VSD closure.

CONCLUSIONS

The micromulti TEE harmonic transducer provided excellent diagnostic intra-operative TEE in neonates and small children without major complications, special attention should be taken for ventilatory parameters in neonates less than 3kg.