The effects of transesophageal echocardiography on hemodynamic variables in small infants undergoing cardiac surgery

Andropoulos, Dean B.; Stayer, Stephen A.; Bent, Sabrina T.; Campos, Carlos José Reis de; Fraser, Charles D.

doi:10.1016/s1053-0770(00)90005-3

Cited by 29 publications

(10 citation statements)

References 12 publications

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“…Andropoulos and colleagues [7] demonstrated the safety of TEE in 23 infants who weighed between 2 and 5 kg; however, the experience was limited to biplane imaging. Bruce and colleagues [6] described the use of a miniaturized ultrasound transducer-tipped catheter, originally designed for intracardiac use, as an alternative to TEE for very small infants.…”

Section: Commentmentioning

confidence: 99%

Initial Experience With a Miniaturized Multiplane Transesophageal Probe in Small Infants Undergoing Cardiac Operations

Zyblewski¹,

Shirali²,

Forbus³

et al. 2010

The Annals of Thoracic Surgery

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Purpose There has been reluctance to use intraoperative transesophageal echocardiography (TEE) in small infants. We assessed the utility and safety of a new miniaturized multiplane micro-TEE probe in small infants undergoing cardiac operations. Description Hemodynamic and ventilation variables were prospectively recorded before and after micro-TEE insertion and removal in infants weighing 5 kg or less undergoing cardiac operations. Evaluation The study included 42 patients with a mean weight of 3.6 ± 0.9 kg (range, 1.7 to 5 kg). All probe insertions were successful. There were no complications or clinically significant changes in hemodynamic or ventilation variables. Information provided by TEE resulted in surgical revision in 6 of the 42 patients. Conclusions The micro-TEE provides high quality, useful diagnostic images without hemodynamic or ventilation compromise in small infants undergoing cardiac operations. This advance is important with the growing trend towards complete repair of complex structural heart disease in small infants.

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Section: Commentmentioning

confidence: 99%

Initial Experience With a Miniaturized Multiplane Transesophageal Probe in Small Infants Undergoing Cardiac Operations

Zyblewski¹,

Shirali²,

Forbus³

et al. 2010

The Annals of Thoracic Surgery

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“…The utility, limitations, 1-12 and complications [13][14][15][16][17][18][19][20][21][22] of standard equipment and protocols 23,24 for transesophageal echocardiography (TEE) in patients with congenital heart disease have been well established. However, there remains a subset of the small and most critically ill infants in whom TEE is performed with either an intracardiac transducer or a miniaturized transesophageal transducer.…”

mentioning

confidence: 99%

Transesophageal Echocardiography in Critically Ill Acute Postoperative Infants: Comparison of AcuNav Intracardiac Echocardiographic and microTEE Miniaturized Transducers

Ferns

Komarlu

Bergen

et al. 2012

Journal of the American Society of Echocardiography

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“…(31) A realistic problem with TOE in small children is possible probe compression of the airway and big vessels, leading to desaturation (75) and haemodynamic compromise. (76) Hypertrophic cardiomyopathy (HCM) can be diagnosed with TOE and also falls in the category I of indications. (77) Abnormal motion of the anterior leaflet of the mitral valve onto a hypertrophic interventricular septum during late systole leads to a high pressure gradient across the left ventricular outflow tract as well as dynamic TOE is an essential tool during surgical intervention for endocarditis.…”

Section: Figurementioning

confidence: 99%

The role of peri-operative transoesophageal echocardiography

Swanevelder

2017

SAHJ

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The role of peri-operative transoesophageal echocardiography cardiovascular surgery. (5,6,7,8,9,10) More recent retrospective analyses of prospectively collected data suggest that around 5.6% of surgical procedures are altered on the basis of intra-operative echocardiographic findings and that there are cost-benefit savings particularly during combined valve and graft operations. (11,12,13) Recently, the roles for peri-operative echocardiography have also extended to include intensive care (14,15) and non-cardiac surgery. (16,17,18) Although it is complex to scientifically prove the benefits of a diagnostic monitor, TOE has been shown to strongly influence intra-operative anaesthetic decisions, particularly in patients with increased risk factors for haemodynamic instability or myocardial ischaemia. In a prospective observational case series of 98 patients undergoing abdominal surgery, the judgement of the anaesthetists was that TOE led to useful alterations in intraoperative care such as administration of fluids, vasoactive drugs and β blockers. In some patients, use of the pulmonary artery catheter was obviated. (19) Similarly, in another case series comprising 90 patients undergoing vascular, visceral and chest surgery, TOE directed changes in drug (47%) and fluid therapy (24%). PERI-OPERATIVE TOE IntroductIonIn 1976 transoesophageal echocardiography (TOE) was introduced into clinical practice.(1) Within a decade, its use extended from cardiology departments into the cardiac surgical arena. However,at that time few probes were available for the operating theatre.Indeed in a report from the United States in 1988, only about 50 TOE probes were accessible for intra-operative use.(2) Furthermore, despite its utility for cardiac surgery, it became evident that few cardiologists were able to spend long periods in the operating theatre. Over time much enthusiasm and expertise for TOE has developed amongst cardiac anaesthesiologists, and by 2001, 94%of respondents in a survey of the Society of CardiovascularAnaesthesiologists utilised intra-operative echocardiography in their routine practice.Over the past 30 years technology has improved tremendously and intra-operative TOE has become an established imaging modality and the gold standard intra-operative cardiac monitor and diagnostic tool in certain cardiac procedures, e.g. mitral valve repair, congenital heart surgery, etc. IndIcAtIons And PrActIcE guIdElInEsEarly experience with the use of peri-operative echocardiography was obtained from its application in cardiac anaesthetic practice; recently however, its role has extended to include non-cardiac surgery and intensive care. Category I indications are supported by strong evidence and expert opinion that TOE is indicated, very useful and will improve patient outcome. These category I indications encompass the everyday practice of the intra-operative anaesthetist-echocardiographer and will be discussed in more detail in this review.Category II indications are supported by weaker evidence and less expert opinion ...

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The effects of transesophageal echocardiography on hemodynamic variables in small infants undergoing cardiac surgery

Cited by 29 publications

References 12 publications

Initial Experience With a Miniaturized Multiplane Transesophageal Probe in Small Infants Undergoing Cardiac Operations

Initial Experience With a Miniaturized Multiplane Transesophageal Probe in Small Infants Undergoing Cardiac Operations

Transesophageal Echocardiography in Critically Ill Acute Postoperative Infants: Comparison of AcuNav Intracardiac Echocardiographic and microTEE Miniaturized Transducers

The role of peri-operative transoesophageal echocardiography

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