Continuous transoesophageal echocardiography monitoring during weaning from cardiopulmonary bypass in children

Ninomiya, Junichi; Yamauchi, Hitoshi; Hosaka, Hiroki; Ishii, Yôsuke; Terada, Kohsuke; Sugimoto, Takeshi; Yamauchi, Shigeo; Yajima, Toshitaka; Bessho, Ryuzo; Fujii, Masahiro; Hinokiyama, Kazuhiro; Tanaka, Shigeo

doi:10.1016/s0967-2109(96)00062-2

Cited by 8 publications

(2 citation statements)

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“…1 Benefits include the detection of residual lesions and the provision of information regarding ventricular function and hemodynamics that may aid in postoperative management. 2–4 Intraoperative imaging was originally performed via the epicardial approach, 5, 6 but with the development of transesophageal transducers, 7, 8 that modality has gained popularity. However, epicardial echo (e-echo) is often preferred over the transesophageal approach for evaluation of certain anatomy, and in small infants and neonates.…”

Section: Introductionmentioning

confidence: 99%

“…Intraoperative postcardiopulmonary bypass echocardiography (echo) is routinely performed to assess the surgical repair of congenital heart defects . Benefits include the detection of residual lesions and the provision of information regarding ventricular function and hemodynamics that may aid in postoperative management . Intraoperative imaging was originally performed via the epicardial approach, but with the development of transesophageal transducers, that modality has gained popularity.…”

Section: Introductionmentioning

confidence: 99%

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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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