Hascoët Sébastien, Peyre Marianne, Hadeed Khaled, Alacoque Xavier, Chausseray Gérald, Fesseau Rose, Amadieu Romain, Léobon Bertrand, Berthomieu Lionel, Dulac Yves, Acar Philippe
Paediatric Cardiology Unit, Children Hospital, Toulouse University Hospital, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
Department of Anesthesiology, Children Hospital, Toulouse University Hospital, 31059 Toulouse cedex 9, France.
Arch Cardiovasc Dis. 2014 Jun-Jul;107(6-7):361-70. doi: 10.1016/j.acvd.2014.05.001. Epub 2014 Jul 1.
Transoesophageal echocardiography (TOE) is feasible in neonates using a miniaturized probe, but is not widely used because of low imaging quality.
To assess handling and imaging quality of a new release of a micro-TOE probe in children.
Thirty-eight consecutive children, enrolled during February and May 2013, underwent TOE with the Philips S8-3t probe. Insertion, handling and image quality were assessed.
The 38 children (aged 7days to 12years; weight 3.1-27kg) underwent 75 TOE (30 [40.0%] before cardiac surgery, 31 [41.3%] after cardiac surgery, 4 [5.3%] during a percutaneous procedure, 10 [13.3%] in the intensive care unit). Insertion of the micro-TOE probe was 'very easy' in 37/38 patients (97.4%). Handling was better in the lightest children (P=0.001). Image quality was mainly 'good' or 'very good', with no significant changes between preoperative and postoperative examinations or over time. Total scores (insertion, handling, image quality) were significantly better in the lightest children (P=0.02). Preoperative TOE did not provide additional information over transthoracic echocardiography. Postoperative TOE was useful to assess surgical results, but no residual lesions required extracorporeal circulation return. Micro-TOE was useful during the postoperative care of neonatal surgery with open breastbone to assess the surgical result and ventricular function. It was also useful to guide extracorporeal membrane oxygenation (ECMO) indication and withdrawal; and was a useful guide for percutaneous procedures.
Micro-multiplane TOE is safe and efficient for use in neonates and children. This minimally invasive tool increases the impact of TOE in paediatric cardiology.
使用小型探头,经食管超声心动图(TOE)在新生儿中是可行的,但由于成像质量低,未得到广泛应用。
评估新一代微型TOE探头在儿童中的操作及成像质量。
2013年2月至5月连续纳入38例儿童,使用飞利浦S8 - 3t探头进行TOE检查。评估探头插入、操作及图像质量。
38例儿童(年龄7天至12岁;体重3.1 - 27kg)接受了75次TOE检查(心脏手术前30次[40.0%],心脏手术后31次[41.3%],经皮操作期间4次[5.3%],重症监护病房10次[13.3%])。37/38例患者(97.4%)插入微型TOE探头“非常容易”。最轻的儿童操作情况更好(P = 0.001)。图像质量主要为“好”或“非常好”,术前和术后检查之间或随时间无显著变化。最轻的儿童总分(插入、操作、图像质量)明显更好(P = 0.02)。术前TOE相比经胸超声心动图未提供更多信息。术后TOE有助于评估手术结果,但无需体外循环恢复的残留病变。微型TOE在胸骨开放的新生儿手术后护理中有助于评估手术结果和心室功能。它也有助于指导体外膜肺氧合(ECMO)的指征和撤除;并且是经皮操作的有用指导。
微型多平面TOE在新生儿和儿童中使用安全且有效。这种微创工具增加了TOE在儿科心脏病学中的影响力。