Ma Xiao-Jing, Huang Guo-Ying, Liang Xue-Cun, Chen Zhang-Gen, Jia Bing, Li Xin, Ye Ming
Paediatric Heart Center, Children's Hospital of Fudan University, Department of Paediatrics, Shanghai Medical School, Fudan University, Shanghai, People's Republic of China.
Cardiol Young. 2007 Jun;17(3):301-6. doi: 10.1017/S1047951107000303. Epub 2007 Apr 20.
To evaluate the role of transoesophageal echocardiography and problems related to safety during the surgical repair of congenital cardiac malformations in children.
We examined the transoesophageal recordings made in 350 children with congenital cardiac diseases, aged from 2 months to 17 years and 9 months, with a median age of 2.7 years, tracings having been taken both before and after cardiopulmonary bypass. All patients had been scanned by transthoracic echocardiography before the operative procedures.
Preoperative transoesophageal echocardiography added additional findings, or changed the diagnoses made using transthoracic echocardiography, in 33 cases (9.4%), among which the findings had therapeutic significance in 23 cases (6.6%) that altered the planned surgical procedures. Residual problems or sequels were detected by postoperative transoesophageal echocardiography in 57 cases (16.3%), with 13 patients (3.7%) requiring instant intervention or return to bypass for modifications of the surgical procedures. We encountered no severe complications due to the performance of transoesophageal echocardiography. Mild complications occurred in only 2 patients (0.6%).
Transoesophageal echocardiography is a useful tool with which to determine the strategies for treatment in the perioperative period, and to improve the quality of surgical procedures in children with congenital cardiac diseases. Complications were few, but still deserved careful attention to detail.
评估经食管超声心动图在小儿先天性心脏畸形手术修复中的作用以及与安全性相关的问题。
我们检查了350例先天性心脏病患儿的经食管超声心动图记录，这些患儿年龄从2个月至17岁9个月，中位年龄为2.7岁，记录在体外循环前后均有获取。所有患者在手术前均已接受经胸超声心动图检查。
术前经食管超声心动图在33例（9.4%）中发现了额外的结果，或改变了经胸超声心动图做出的诊断，其中23例（6.6%）的结果具有治疗意义，改变了计划的手术程序。术后经食管超声心动图在57例（16.3%）中检测到残余问题或后遗症，13例患者（3.7%）需要立即干预或重新进行体外循环以修改手术程序。我们未遇到因经食管超声心动图检查而导致的严重并发症。仅2例患者（0.6%）出现轻度并发症。
经食管超声心动图是确定围手术期治疗策略以及提高先天性心脏病患儿手术质量的有用工具。并发症较少，但仍值得对细节予以仔细关注。
