Value of transesophageal echocardiography during repair of congenital heart defects.

Two-dimensional transesophageal color Doppler echocardiography was employed intraoperatively in 30 children undergoing repair of a variety of simple and complex cardiac malformations. There were 16 female and 14 male patients, with a mean age of 9 +/- 3 years (range, 4 to 13 years) and a mean weight of 31 +/- 9 kg (range, 16 to 50 kg), 16 children weighing less than 30 kg. A standard, commercially available transesophageal echocardiography probe (5 MHz, 64 elements) was used in all patients without complications. Transesophageal echocardiography proved helpful in selecting the surgical approach, in assessing the adequacy of surgical repair, in detecting residual intracardiac shunts, and in allowing uninterrupted monitoring of ventricular performance throughout the procedure. Our initial experience suggests that transesophageal echocardiography is a valuable tool to be used in children with congenital cardiac malformations, particularly in those requiring complex intracardiac procedures. The amount of information obtained by the surgeon should favor the routine use of transesophageal echocardiography during open heart procedures and stimulate the development of probes to be safely used even in infants and newborns.