The impact of additional epicardial imaging to transesophageal echocardiography on intraoperative detection of residual lesions in congenital heart surgery

摘要: Objective Transesophageal echocardiography is the primary intraoperative imaging modality used to evaluate cardiac surgery. Its predecessor, epicardial echocardiography, enables visualization of certain cardiovascular structures that are beyond visual scope transesophageal echocardiography. We review current use analyze its contemporary application and benefit. Methods A retrospective echocardiograms 1204 children undergoing bypass surgery between January 2007 December 2009 was performed. The incidence use, revisions, early reinterventions were analyzed. Results Epicardial performed in 7.9% all studies: alone (n = 38) + (n = 57). patients with contraindications for In group, indications obtain additional information by assessment branch pulmonary arteries (40%), coronary (28%), aortic arch/Blalock–Taussig shunt (14%), Glenn/Fontan circuit (9%), veins/baffles (7%), residual ventricular septal defects (1.7%). overall surgical revision 10.2%, consisting 21% 5.3% group ( P  = .01), 9.8%  = .02). Intraoperative revisions indicated after mostly related extracardiac (77%), whereas they intracardiac (80.7%)  = .0002). Early reintervention artery Glenn obstructions, majority (75%) previously known stenosis or interventions on arteries. Conclusions detects lesions not visualized most frequently addition standard may decrease need reintervention.