Intraoperative Echocardiography in Pediatric Heart Disease

Abstract

Intraoperative echocardiography has become an invaluable diagnostic and monitoring technique in surgery for pediatric heart disease. Transesophageal echocardiography (TEE) has largely replaced epicardial echocardiography as the pre ferred approach. TEE has the advantage of allowing serial assessment of anatomy and function with no interruption of surgery. Recent advances in transducer technology of the TEE probe and the introduction of novel modes of imaging have greatly increased the applicability of TEE in pediatric congenital cardiac repair. TEE has been used for a spectrum of congenital lesions such as valve anomalies, shunts, ob structions, and complex heart defects, as well as to monitor for myocardial ischemia and left ventricular preload. Expe rience and evidence suggest that intraoperative TEE can improve clinical outcomes in children undergoing repair of congenital cardiac defects. The safety and efficacy of TEE in children have been well established. This article outlines the development of intraoperative echocardiography and dis cusses TEE as a diagnostic tool in the management of pedi atric heart disease.