Value of Intraoperative Transesophageal Echocardiography during tetralogy of Fallot repair
This study was performed to define a value of intraoperative transesophageal echocardiography (ITEE) during tetralogy of Fallot (ToF) repair.
Methods. Intraoperatively 64 patients with ToF were examined by TEE before and after cardiopulmonary bypass (CPB).
Results. All preoperative diagnosis were confirmed by ITEE, except two cases when ITEE excluded diagnosis of PA branches’ stenosis and one case when additional muscular ventricular septal defect was detected. Was revealed a strong correlation of PV annulus Z-score diameter by ITEE with intraoperative data (r=0,802; p<0.00001). Significant RVOTO was detected by ITEE in two patients (3,1%) and three patients (4,7%) underwent a reoperation on pulmonary branches due to ITEE data.
Conclusions. ITEE imaging is a valuable, safe and accurate tool for anatomical, hemodynamic, and functional assessment during ToF repair.
2. Hahn RT, Abraham T, Adams MS, Bruce CJ, Glas KE, Lang RM et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2013; 26:921.
3. Guzeltas A, Ozyilmaz I, Tanidir C, Odemis E, Tola HT, Ergul Y, et al. The significance of transesophageal echocardiography in assessing congenital heart disease: our experience. Congenital Heart Disease. 2014; 9: 300–306.
4. Puri GD,Raj R, Tacy TA. Transesophageal echocardiography for tetralogy of Fallot repair: What a perioperative physician need to know? Journal of Perioperative Echocardiography. July-December 2014;2(2):51–57.
5. Fraser CD, McKenzie ED, Cooley DA. Tetralogy of Fallot: surgical management individualized to the patient. Ann Thorac Surg. 71 (2001); 1556–1563.
6. Soo-Jin Kim, Sin-Ae Park, Jinyoung Song, Woo Sub Shim, Eun Young Choi, Sang Yoon Lee. The Role of Transesophageal Echocardiography During Surgery for Patients With Tetralogy of Fallot. Pediatric Cardiology. Feb 2013;34, 2; 240–244.
7. Shen-Kou Tsai. The role of transesophageal echocardiography in clinical use Journal of the Chinese Medical Association.76 (2013); 661–672.
8. Garg R, Murthy K, Rao S, Muralidhar K. Intra-operative transesophageal echocardiography in congenital heart disease. Ann Card Anaesth. 2009;12:166.