ABSTRACT

Aim:

Intraoperative transesophageal echocardiography ( TEE) has been increasingly utilized du-ring repair of congenital cardiac defects. TEE plays a major role in confirmation of the preoperative diagnosis, residual defects, and the need to return the bypass after repair. We want to report our initial experience with intraoperative TEE in 67 patients over a 3-year period.

Patients and Methots:

Patients mean age was 6.8 ± 5.2 years. A pediatric biplane transesophage-al probe was used in all patients. TEE was performed both prebypass and postbypass periods.

Results:

The preoperative diagnosis was correctly confirmed by TEE in 61 of 67 cases (91.04 %) with minor variances in 4 cases ( 6.3%) and two major variances (2.98 %). Surgical management decisions changed as a result of TEE findings in this two patients. We assessed residual lesions, ventricular function and preload with TEE after postbypass. Postoperative TEE findings showed no residual defect in 47 ( 70.14 %), trivial or mild residual defects in 17 patients ( 25.37 %). There were moderate severe residuel defects in 2 cases ( 2.98%). Complex cardiac congenital defect with one patient was died in the early postperative period. Medical alterations of management were required in 17.91% of cases as a result of postbypass TEE findings. There were no complications in any of the 67 subjects due to TEE study.

Conclusions:

The intraoperative TEE offers significant advantages in the management patients undergoing repair of congenital heart disease. Our results confirm the potential benefits of intrao-perative TEE during heart surgery to identify problems that need immediate surgical intervention and to assist intraoperative medical management.