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Article: An evolving role of transesophageal echocardiography for the monitoring of interventional catheterization in children

TitleAn evolving role of transesophageal echocardiography for the monitoring of interventional catheterization in children
Authors
Issue Date1999
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
Citation
Clinical Cardiology, 1999, v. 22 n. 12, p. 804-810 How to Cite?
AbstractBackground and hypothesis: Transesophageal echocardiography (TEE) is increasingly utilized for the monitoring of interventional cardiac catheterization in children. The initial nondiscriminant use is giving way to a more selective approach. The current role and usefulness of this imaging modality are described. Methods: Between 1991 and 1995, 44 patients (mean age 7.4 ± 5 years, weight 22.8 ± 14.2 kg) underwent interventional cardiac catheterizations performed under TEE monitoring. The interventional procedures included (1) those involving creation, enlargement, or closure of an interatrial communication; (2) balloon dilatation of stenotic lesions; and (3) occlusion of arterial ducts. Transesophageal echocardiographic monitoring was judged to be either of great value, contributory, or of little use if the interventional procedure and choice of instrument relied heavily upon, was guided, or not affected by the information obtained from the ultrasonic investigation, respectively. Results: Transesophageal echocardiography was judged to be of great value in the monitoring of 18 (40%) procedures involving either the creation, enlargement, or closure of interatrial communications. This included 4 transseptal punctures, 4 blade septectomies for relieving restrictive atrial septal defects (n = 3) and an enlargement of the communication between the superior and inferior chambers of the divided left atrium in cortriatriatum, and 11 closures of a secundum atrial septal defect. Only the ultrasonic monitoring could clearly visualize the interatrial partition to provide real-time guidance on the positioning of the instrument to carry out the invasive procedures. Transesophageal echocardiography provided clear images of the hinge points of the aortic and mitral valves, the dimension of the narrowed pulmonary venous pathway in patients after venous switch operation. This facilitated the choice of the correct size of the balloon for dilatation in 11 patients (24%) and provided immediate postdilatation hemodynamic assessment. As for balloon dilation of subvalvar ventricular outflow tract obstruction (n = 3), aortic coarctation (n = 6), and occlusion of persistent arterial duct (n = 7), TEE offered no obvious advantage over fluoroscopy with angiography. The monitoring was judged to be of little value for the 16 (36%) procedures. Conclusion: Transesophageal echocardiographic monitoring is of great value in interventional procedures involving the atrial septum and enhances interventional procedures involving obstructive lesions of the left heart in children.
Persistent Identifierhttp://hdl.handle.net/10722/170297
ISSN
2015 Impact Factor: 2.431
2015 SCImago Journal Rankings: 1.309
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, YFen_US
dc.contributor.authorLeung, MPen_US
dc.contributor.authorLee, Jen_US
dc.contributor.authorYung, TCen_US
dc.date.accessioned2012-10-30T06:07:18Z-
dc.date.available2012-10-30T06:07:18Z-
dc.date.issued1999en_US
dc.identifier.citationClinical Cardiology, 1999, v. 22 n. 12, p. 804-810en_US
dc.identifier.issn0160-9289en_US
dc.identifier.urihttp://hdl.handle.net/10722/170297-
dc.description.abstractBackground and hypothesis: Transesophageal echocardiography (TEE) is increasingly utilized for the monitoring of interventional cardiac catheterization in children. The initial nondiscriminant use is giving way to a more selective approach. The current role and usefulness of this imaging modality are described. Methods: Between 1991 and 1995, 44 patients (mean age 7.4 ± 5 years, weight 22.8 ± 14.2 kg) underwent interventional cardiac catheterizations performed under TEE monitoring. The interventional procedures included (1) those involving creation, enlargement, or closure of an interatrial communication; (2) balloon dilatation of stenotic lesions; and (3) occlusion of arterial ducts. Transesophageal echocardiographic monitoring was judged to be either of great value, contributory, or of little use if the interventional procedure and choice of instrument relied heavily upon, was guided, or not affected by the information obtained from the ultrasonic investigation, respectively. Results: Transesophageal echocardiography was judged to be of great value in the monitoring of 18 (40%) procedures involving either the creation, enlargement, or closure of interatrial communications. This included 4 transseptal punctures, 4 blade septectomies for relieving restrictive atrial septal defects (n = 3) and an enlargement of the communication between the superior and inferior chambers of the divided left atrium in cortriatriatum, and 11 closures of a secundum atrial septal defect. Only the ultrasonic monitoring could clearly visualize the interatrial partition to provide real-time guidance on the positioning of the instrument to carry out the invasive procedures. Transesophageal echocardiography provided clear images of the hinge points of the aortic and mitral valves, the dimension of the narrowed pulmonary venous pathway in patients after venous switch operation. This facilitated the choice of the correct size of the balloon for dilatation in 11 patients (24%) and provided immediate postdilatation hemodynamic assessment. As for balloon dilation of subvalvar ventricular outflow tract obstruction (n = 3), aortic coarctation (n = 6), and occlusion of persistent arterial duct (n = 7), TEE offered no obvious advantage over fluoroscopy with angiography. The monitoring was judged to be of little value for the 16 (36%) procedures. Conclusion: Transesophageal echocardiographic monitoring is of great value in interventional procedures involving the atrial septum and enhances interventional procedures involving obstructive lesions of the left heart in children.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.orgen_US
dc.relation.ispartofClinical Cardiologyen_US
dc.subject.meshBalloon Dilationen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshEchocardiography, Transesophageal - Methodsen_US
dc.subject.meshHeart Atria - Abnormalities - Ultrasonographyen_US
dc.subject.meshHeart Catheterization - Methodsen_US
dc.subject.meshHeart Septal Defects, Atrial - Therapy - Ultrasonographyen_US
dc.subject.meshHeart Valve Diseases - Therapy - Ultrasonographyen_US
dc.subject.meshHumansen_US
dc.subject.meshMonitoring, Physiologic - Methodsen_US
dc.titleAn evolving role of transesophageal echocardiography for the monitoring of interventional catheterization in childrenen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1002/clc.4960221210-
dc.identifier.pmid10626083-
dc.identifier.scopuseid_2-s2.0-0032749132en_US
dc.identifier.hkuros47534-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032749132&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume22en_US
dc.identifier.issue12en_US
dc.identifier.spage804en_US
dc.identifier.epage810en_US
dc.identifier.isiWOS:000084070700008-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.scopusauthoridLeung, MP=7201944800en_US
dc.identifier.scopusauthoridLee, J=7601463758en_US
dc.identifier.scopusauthoridYung, TC=9132842300en_US

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