Transesophageal Echocardiography in Pediatric Patients: Preliminary Results

Lam, Jan; Neirotti, Rodolfo A.; Nijveld, A.; Schuller, J.; Blom-Muilwijk, Connie M.; Visser, Cees A.

doi:10.1016/s0894-7317(14)80159-4

Cited by 31 publications

(10 citation statements)

References 5 publications

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“…A total rate of complications of 1.25 %seems to be acceptable when balanced against the benefits of this method. Other authors reported complication rates ranging from 0 %to 4.8 % (9,41,42).…”

Section: Pericardial Effusion and Constrictionmentioning

confidence: 99%

Impact of Perioperative Transesophageal Echocardiography on Cardiac Surgery

Loick

Scheld²,

Aken³

1997

Thorac cardiovasc Surg

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Transesophageal echocardiography (TEE) is recognized as a semi-invasive technique with increasing impact on diagnostic tools in cardiac surgery. Particularly, TEE plays a role in patients undergoing cardiac valve repair or congenital heart surgery with regard to the assessment of the operative success. Other proven roles of TEE are in evaluating atheromatous disease of the aortic arch, detection of aortic dissection and aneurysm, and diagnosis of pathologic findings within the heart and the pericardial sac. The power of TEE in diagnosis and decision making may lead to an improved clinical outcome which in turn may lead to a reduction in financial efforts.

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Section: Pericardial Effusion and Constrictionmentioning

confidence: 99%

Impact of Perioperative Transesophageal Echocardiography on Cardiac Surgery

Loick

Scheld²,

Aken³

1997

Thorac cardiovasc Surg

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“…[6][7][8][9][10][11][12][13][14] Development of miniaturized probes in 1990 has generated a number of studies, which have demonstrated that TEE can be performed safely in the pediatric population and provide substantial benefit as well. [15][16][17][18] Several authors have reported on the positive impact of intraoperative echocardiography on patients' outcomes. 1 The field of applications for this monitoring and diagnostic technique is ever expanding as more evidence emerges for the benefits of intraoperative echocardiography.…”

Section: Cost Analysismentioning

confidence: 99%

Impact and Cost Effectiveness of Routine Intraoperative Transthoracic and Transesophageal Echocardiography on Surgical Decision Making in Pediatric Cardiac Surgery

Madhavan¹,

Ghuman²,

Mishra³

et al. 2014

Journal of Perioperative Echocardiography

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Introduction Congenital heart diseases (CHD) present with wide spectrum of lesions leading to diagnostic dilemmas and it is quite possible to miss correct diagnosis during preoperative transthoracic echocardiography (TTE) in an inadequately sedated child, especially in a busy outpatient setting. It is a routine practice in our center to do baseline TTE after induction of anesthesia followed by pre and postcardiopulmonary bypass (CPB) transesophageal echocardiography (TEE) in all CHD patients thus helping us review our surgical plan. Materials and methods All pediatric patients <18 years undergoing cardiac surgery from January 2013 to December 2013 at our tertiary care center in whom perioperative echocardiograhy was done were included. Appropriate sized TTE and TEE probes were used with the Philips iE33 echocardiography platform (Philips, Andover, MA). Results Out of total 352 pediatric cardiac surgical patients, perioperative echocardiography was done in 347(98.5%) patients. Baseline TTE showed new findings leading to change in surgical plan in 11 (3.1%) patients while additional new findings in baseline TEE were seen in 9 (2.6%). Post bypass TEE showed residual lesions requiring a CPB rerun in 19 (5.5%) patients. Intraoperative echocardiography was found to be cost effective with an estimated savings per patient of ₹ 3950 to 5373($61 - 83). Conclusion Intraoperative echocardiography is an important tool in armamentarium of perioperative physician which can be used to review diagnosis and help to formulate an informed surgical plan. Post-bypass transesophageal echocardiography is also useful as it identifies the residual lesions and establishes anatomical correction, which ultimately translates to lesser redo surgeries and a better postoperative outcome. How to cite this article Mishra A, Madhavan JS, Ghuman BPS, Raj R, Kumar A, Dutta V, Negi S, Tandon Y, Kumar A, Arya VK, Kumar B, Jayant A, Puri GD. Impact and Cost Effectiveness of Routine Intraoperative Transthoracic and Transesophageal Echocardiography on Surgical Decision Making in Pediatric Cardiac Surgery. J Perioper Echocardiogr 2014;2(1):3-9.

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“…2 Anatomic abnormalities producing esophageal intubation failure include a double aortic arch, 37 cervical osteophytes 21 and decreased cervical range of motion, 28 swallowing impairment, mucosal abnormalities such as prior radiation exposure or decreased saliva production, 28 prior tracheostomy, 38 and an inflated endotracheal balloon. Several suggestions have been advanced to overcome failed intubation.…”

Section: Failure To Intubate the Esophagusmentioning

confidence: 99%

Transesophageal echocardiography-related complications

Côté

Denault

2008

Can J Anesth/J Can Anesth

101

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Purpose: The use of transesophageal echocardiography has increased over the past several years. It is generally considered a safe diagnostic and monitoring tool. Whereas complications associated with echocardiographic examination rarely occur, such complications must be known to echocardiographers performing these examinations. The purpose of this review is to summarize potential complications associated with transesophageal echocardiography. Sources:A systematic search of the English and French literature was undertaken using PubMed from the National Library of Medicine. Relevant articles were obtained from a Medline search spanning the years 1975 -2007, and their reference lists were used to retrieve additional articles. Principal findings:Complications of transesophageal echocardiography are primarily related to the gastrointestinal, cardiovascular, and respiratory systems, and include infection, toxic drug reaction, local reaction through contamination of the probe, and ultrasound cavitation. Strategies to prevent these complications are reviewed. Conclusion:Whereas transesophageal echocardiography is associated with a low complication rate, the echocardiographer must be knowledgeable about the types of complications and their predisposing factors, and should be meticulous in preventing their occurrence.

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Transesophageal Echocardiography in Pediatric Patients: Preliminary Results

Cited by 31 publications

References 5 publications

Impact of Perioperative Transesophageal Echocardiography on Cardiac Surgery

Impact of Perioperative Transesophageal Echocardiography on Cardiac Surgery

Impact and Cost Effectiveness of Routine Intraoperative Transthoracic and Transesophageal Echocardiography on Surgical Decision Making in Pediatric Cardiac Surgery

Transesophageal echocardiography-related complications

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