Indications and guidelines for performance of transesophageal echocardiography in the patient with pediatric acquired or congenital heart disease

Task Force 2: Pediatric Cardiology Fellowship Training in Noninvasive Cardiac Imaging

“…Imaging protocol guidelines for performance of pediatric TTE, TEE, and fetal echocardiograms have been published by the American Society of Echocardiography. [3][4][5][6][7][8] Besides imaging protocols, the echocardiography laboratory should have in place a comprehensive normative dataset or Z-score database encompassing the full range of body sizes and ages encountered in a pediatric/congenital laboratory against which to compare measurements performed in the laboratory; this can be accomplished through 1 of several currently available pediatric echocardiography normative databases.…”

“…Moreover, during the course of their 3-year training, fellows will often encounter situations in which they are e60 Circulation August 11, 2015 required to order, review, and/or present TEE studies. Hence, they should be familiar with the general aspects of the procedure, including its advantages and limitations, 5 as well as the individual TEE views and how they are utilized to evaluate congenital and acquired heart disease.…”

“…The studies should be performed under the direct supervision of a dedicated pediatric cardiologist-echocardiographer or other qualified physician with specialized expertise in pediatric/congenital heart TEE. 5 • Trainees should understand oropharyngeal anatomy and the technique of esophageal intubation, as well as the potential risks of TEE and contraindications for the procedure.…”

“…Trainees should be expected to acquire the skills necessary to perform a complete diagnostic evaluation of the heart, utilizing the various TEE probe manipulations and esophageal positions. [5][6][7] Obtaining a complete study necessitates the use of the methods common to all e62 Circulation August 11, 2015…”

Intraoperative Transesophageal Echocardiography for Congenital Heart Disease

“…According to the "practice guidelines for perioperative TEE", TEE should be used in all adult open heart procedures (Thys et al, 2010). The task force of American Society of Echocardiography also described surgery for congenital heart disease is an indication for performance of TEE (Ayres et al, 2005).…”