BIPLANE INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN CONGENITAL HEART-DISEASE

被引:39
作者
OLEARY, PW
HAGLER, DJ
SEWARD, JB
TAJIK, AJ
SCHAFF, HV
PUGA, FJ
DANIELSON, GK
机构
[1] MAYO CLIN & MAYO FDN,DIV CARDIOVASC DIS & INTERNAL MED,ROCHESTER,MN 55905
[2] MAYO CLIN & MAYO FDN,DIV THORAC & CARDIOVASC SURG,ROCHESTER,MN 55905
关键词
D O I
10.4065/70.4.317
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To evaluate the accuracy, value, and safety of biplane intraoperative transesophageal echocardiography (TEE) in patients with congenital cardiac malformations. Design: We reviewed the results of the first 104 consecutive biplane intraoperative TEE examinations performed during the repair of congenital heart defects at the Mayo Clinic. Material and Methods: TEE results were analyzed for accuracy of diagnosis, effect on the surgical procedure, and associated complications. In a subjective analysis, the relative contributions and advantages of each imaging plane (transverse and longitudinal) were also assessed. Results: Biplane TEE had ''significant impact'' on intraoperative management in 17 of 104 examinations (16.3%). Preoperative TEE altered the planned procedure in 11 patients (10.6%). Postbypass biplane TEE led to immediate revision of the initial repair in nine patients (8.7%). Patients who underwent modified Fontan operations or subaortic resections had the greatest frequency of significant impact (40% [P = 0.006] and 33% [P = 0.03], respectively). No major complications were associated with TEE. For a complete examination, use of both imaging planes was necessary in all the patients studied. Conclusion: Biplane TEE is an accurate, valuable, and safe addition to the perioperative care of patients with congenital heart disease. Although intraoperative TEE is not needed in all operations for congenital heart disease, we recommend that biplane intraoperative TEE be performed routinely during modified Fontan procedures, subaortic resections, and other intracardiac operations for complex congenital cardiac malformations.
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页码:317 / 326
页数:10
相关论文
共 13 条
[1]  
CYRAN SE, 1991, J CARDIOVASC SURG, V32, P318
[2]  
GILBERT TB, 1992, ANESTH ANALG, V74, P156
[3]   INTRAOPERATIVE TWO-DIMENSIONAL ECHOCARDIOGRAPHY IN CONGENITAL HEART-DISEASE [J].
GUSSENHOVEN, EJ ;
VANHERWERDEN, LA ;
ROELANDT, J ;
LIGTVOET, KM ;
BOS, E ;
WITSENBURG, M .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1987, 9 (03) :565-572
[4]  
HAGLER DJ, 1988, J THORAC CARDIOV SUR, V95, P516
[5]   USEFULNESS OF BIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN NEONATES, INFANTS AND CHILDREN WITH CONGENITAL HEART-DISEASE [J].
LAM, J ;
NEIROTTI, RA ;
LUBBERS, WJ ;
NAEFF, MSJ ;
BLOMMUILWIJK, CM ;
SCHULLER, JL ;
MACARTNEY, FJ ;
VISSER, CA .
AMERICAN JOURNAL OF CARDIOLOGY, 1993, 72 (09) :699-706
[6]  
Lam J, 1991, J Am Soc Echocardiogr, V4, P43
[7]   AORTIC COMPRESSION BY TRANSESOPHAGEAL ECHOCARDIOGRAPHIC PROBE IN INFANTS AND CHILDREN UNDERGOING CARDIAC-SURGERY [J].
LUNN, RJ ;
OLIVER, WC ;
HAGLER, DJ ;
DANIELSON, GK .
ANESTHESIOLOGY, 1992, 77 (03) :587-590
[8]   TRANSESOPHAGEAL REAL-TIME ECHOCARDIOGRAPHY IN INFANTS AND CHILDREN WITH CONGENITAL HEART-DISEASE [J].
RITTER, SB .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (02) :569-580
[9]   INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY OF ATRIOVENTRICULAR SEPTAL-DEFECT [J].
ROBERSON, DA ;
MUHIUDEEN, IA ;
SILVERMAN, NH ;
TURLEY, K ;
HAAS, GS ;
CAHALAN, MK .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (02) :537-545
[10]  
Stumper O, 1991, J Am Soc Echocardiogr, V4, P164