Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T06:04:32.380Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical application of a micro multiplane transoesophageal probe in congenital cardiac disease

Published online by Cambridge University Press:  19 August 2011

Kuberan Pushparajah ,
Owen I. Miller ,
Debbie Rawlins ,
Anna Barlow ,
Kelly Nugent  and
John M. Simpson
Kuberan Pushparajah*
Affiliation:
Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
Owen I. Miller
Affiliation:
Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
Debbie Rawlins
Affiliation:
Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
Anna Barlow
Affiliation:
Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
Kelly Nugent
Affiliation:
Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
John M. Simpson
Affiliation:
Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, London, United Kingdom
*
Correspondence to: K. Pushparajah, BMBS, BMedSci., Specialist Registrar in Paediatric Cardiology, Department of Congenital Heart Disease, Evelina Children's Hospital, Guy's & St Thomas’ NHS Foundation Trust, 6th Floor Sky Office, Westminster Bridge Road, London SE1 7EH, United Kingdom. Tel: +44 207 1884547; Fax: +44 207 1884556; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

To assess the quality of imaging modalities of a new micro multiplane transoesophageal echocardiogram probe.

Method

This is a prospective study of micro transoesophageal echocardiogram S8-3t probe used at a single institution between 15 December, 2009 and 15 March, 2010. The images were compared with standard paediatric or adult probes where possible. Assessors prospectively rated imaging quality – two dimensional, colour flow imaging, pulse wave, and continuous wave Doppler – with a subjective 4-point scale (1 = poor to 4 = excellent).

Results

A total of 24 studies were performed on 23 patients, with a median weight = 11.7 kilograms (2.6–72 kilograms) and a median age of 3 years (0.16–60 years). Of the 23 patients, one neonate (2.8 kilograms) had transient bradycardia on probe insertion. Imaging in patients less than 10 kilograms was of full diagnostic value and new information was obtained in eight out of ten patients. Pulse wave and continuous wave Doppler was consistently good across all weight groups. There were high frame rates and good imaging quality to a depth of 4–6 centimetres in all studies. A comparison with a larger alternative probe was available for 12 studies (weight 11.9–72 kilograms). The median micro transoesophageal two-dimensional image quality score was 3 (2–4) and 4 (3–4) with the comparative probe. For the 10- to 30-kilogram group, image quality with the micro transoesophageal echocardiogram probe was judged as inferior to larger standard probes. Adult sized patients had good imaging of near the field, allowing guidance for percutaneous device closure of the atrial septum.

Conclusion

The micro multiplane transoesophageal echocardiogram probe provides imaging of diagnostic quality in neonates. In larger patients, it offers good imaging of near field structures. In the intermediate-sized child (10–30 kilograms), standard paediatric probes provide better imaging.

Keywords

Micro multiplanetransoesophageal echocardiogramcongenital cardiac diseasepaediatricinterventionintra-operative
Type
Original Articles
Information
Cardiology in the Young , Volume 22 , Issue 2 , 02 March 2012 , pp. 170 - 177
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Sutherland, GR, Stumper, OFW. Transthoracic versus transesophageal echocardiography in the pediatric patient. Curr Opin Pediatr 1993; 5: 598–605.CrossRefGoogle ScholarPubMed
2.Ayres, NA, Miller-Hance, W, Fyfe, DA, et al. Indications and guidelines for performance of transesophageal echocardiography in the patient with pediatric acquired or congenital heart disease: report from the task force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2005; 18: 91–98.CrossRefGoogle ScholarPubMed
3.Stevenson, JG. Incidence of complications in pediatric transoesophageal echocardiography: experience in 1650 cases. J Am Soc Echocardiogr 1999; 12: 527–532.CrossRefGoogle ScholarPubMed
4.Shiota, T, Lewandowski, R, Piel, JE, et al. Micromultiplane transesophageal echocardiographic probe for intraoperative study of congenital heart disease repair in neonates, infants, children, and adults. Am J Cardiol 1999; 83: 292–295; A7.CrossRefGoogle ScholarPubMed
5.Sloth, E, Hasenkam, JM, Sorensen, KE, et al. Pediatric multiplane transesophageal echocardiography in congenital heart disease: new possibilities with a miniaturized probe. J Am Soc Echocardiogr 1996; 9: 622–628.CrossRefGoogle ScholarPubMed
6.Sahn, DJ. Editorial comment. Eur J Echocardiogr 2007; 8: 237–238.CrossRefGoogle Scholar
7.Scohy, TV, Gommers, D, Jan ten Harkel, AD, Deryck, Y, McGhie, J, Bogers, AJ. Intraoperative evaluation of micromultiplane transesophageal echocardiographic probe in surgery for congenital heart disease. Eur J Echocardiogr 2007; 8: 241–246.CrossRefGoogle ScholarPubMed
8.Thijssen, JM. Ultrasonic speckle formation, analysis and processing applied to tissue characterization. Pattern Recognition Lett 2003; 24: 659–675.CrossRefGoogle Scholar
9.Scohy, TV, Gommers, D, Schepp, MN, McGhie, J, de Jong, N, Bogers, AJ. Image quality using a micromultiplane transesophageal echocardiographic probe in older children during cardiac surgery. Eur J Anaesthesiol 2009; 26: 445–447.CrossRefGoogle ScholarPubMed
10.Bettex, DA, Schmidlin, D, Bernath, MA, et al. Intraoperative transesophageal echocardiography in pediatric congenital cardiac surgery: a two-center observational study. Anesth Analg 2003; 97: 1275–1282.CrossRefGoogle ScholarPubMed
11.Balmer, C, Barron, D, Wright, JG, et al. Experience with intraoperative ultrasound in paediatric cardiac surgery. Cardiol Young 2006; 16: 455–462.CrossRefGoogle ScholarPubMed
12.Reynolds, HR, Spevack, DM, Shah, A, et al. Comparison of image quality between a narrow calibre transoesophageal echocardiographic probe and the standard size probe during intraoperative evaluation. J Am Soc Echocardiogr 2004; 17: 1050–1052.CrossRefGoogle ScholarPubMed
13.Scott, PJ, Blackburn, ME, Wharton, GA, Wilson, N, Dickinson, DFD, Gibbs, JL. Transoesophageal echocardiography in neonates, infants and children: applicability and diagnostic value in everyday practice of a cardiothoracic unit. Br Heart J 1992; 68: 488–492.CrossRefGoogle ScholarPubMed
14.Greene, MA, Alexander, JA, Knauf, DG, et al. Endoscopic evaluation of the esophagus in infants and children immediately following intraoperative use of transesophageal echocardiography. Chest 1999; 116: 1247–1250.CrossRefGoogle ScholarPubMed
15.Muhiudeen, RI, Miller-Hance, WC, Silverman, NH. Intraoperative transesophageal echocardiography for pediatric patients with congenital heart disease. Anesth Analg 1998; 87: 1058–1076.CrossRefGoogle Scholar
16.Zyblewski, SC, Shirali, GS, Forbus, GA, et al. Initial experience with a miniaturized multiplane transesophageal probe in small infants undergoing cardiac operations. Ann Thorac Surg 2010; 89: 1990–1994.CrossRefGoogle ScholarPubMed
17.Drinker, LR, Camitta, MG, Herlong, JR, et al. Use of the monoplane intracardiac imaging probe in high-risk infants during congenital heart surgery. Echocardiography 2008; 9: 999–1003.CrossRefGoogle Scholar
18.Cannesson, M, Hénaine, R, Metton, O, et al. Images in cardiovascular medicine. Intraoperative transesophageal echocardiography using a miniaturized transducer in a neonate undergoing Norwood procedure for hypoplastic left heart syndrome. Circulation 2008; 117: 702–703.CrossRefGoogle Scholar