Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T11:54:38.805Z Has data issue: false hasContentIssue false
  • English
  • Français

Intraoperative echocardiographic coronary artery imaging in congenital and acquired heart disease

Published online by Cambridge University Press:  05 February 2020

Deane Yim Open the ORCID record for Deane Yim [Opens in a new window] ,
Luc Mertens ,
Osami Honjo  and
Lynne E. Nield
Deane Yim*
Affiliation:
Division of Paediatric Cardiology, Perth Children’s Hospital, Perth, Australia
Luc Mertens
Affiliation:
Division of Paediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada
Osami Honjo
Affiliation:
Department of Cardiovascular Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Canada
Lynne E. Nield
Affiliation:
Division of Paediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada
*
Author for correspondence: Dr Deane Yim, Division of Paediatric Cardiology, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands, Perth, WA 6009, Australia. Tel: +61-8-6456 2222. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Transoesophageal and epicardial echocardiography are indispensible intraoperative imaging modalities to guide paediatric heart disease surgeries and influence surgical decision-making. A less well-described role of intraoperative imaging is its utility in evaluating coronary artery patency and flow. Focused two-dimensional, colour, and spectral Doppler imaging of the coronary arteries should be performed during surgeries involving coronary manipulation or re-implantation, or in cases where there is unexpected ventricular dysfunction or electrographic signs concerning for ischaemia. Intraoperative imaging allows for any anatomical issues to be detected and addressed promptly in the operating room. Imaging of the coronary arteries should identify unobstructed coronary ostia and proximal course without kinking, angulation, narrowing, or significant calibre change to suggest stenosis or extrinsic compression from neighbouring structures. The aim of this review is to highlight the usefulness of transoesophageal and epicardial echocardiography in evaluating coronary artery patency and flow, provide a how-to guide for optimal imaging, and to introduce a practical guideline to achieve best clinical practice.

Keywords

TransoesophagealTOETEEcoronaryepicardialechocardiography
Type
Review Article
Information
Cardiology in the Young , Volume 30 , Issue 2 , February 2020 , pp. 153 - 161
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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

Zwicky, P, Daniel, WG, Mugge, A, Lichtlen, PR.Imaging of Coronary Arteries by Color-Coded Transesophageal Doppler Echocardiography. Am J Cardiol 1988; 62: 639–640.10.1016/0002-9149(88)90671-6CrossRefGoogle ScholarPubMed
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: 91–98.10.1016/j.echo.2004.11.004CrossRefGoogle ScholarPubMed
Eltzschig, HK, Rosenberger, P, Loffler, M, et al.Impact of Intraoperative Transesophageal Echocardiography on Surgical Decisions in 12,566 Patients Undergoing Cardiac Surgery. Ann Thorac Surg 2008; 85: 845–852.10.1016/j.athoracsur.2007.11.015CrossRefGoogle ScholarPubMed
Gurbuz, AT, Hecht, ML, Arslan, AH.Intraoperative Transesophageal Echocardiography Modifies Strategy in Off-Pump Coronary Artery Bypass Grafting. Ann Thorac Surg 2007; 83: 1035–1040.10.1016/j.athoracsur.2006.10.019CrossRefGoogle ScholarPubMed
Dragulescu, A, Golding, F, Van Arsdell, G, et al.The Impact of Additional Epicardial Imaging to Transesophageal Echocardiography on Intraoperative Detection of Residual Lesions in Congenital Heart Surgery. J Thorac Cardiovasc Surg 2012; 143: 361–367.10.1016/j.jtcvs.2011.06.010CrossRefGoogle ScholarPubMed
Fraser, CD, Liu, RH, Zhou, X, et al.Valve-Sparing Aortic Root Replacement in Children: Outcomes from 100 Consecutive Cases. J Thorac Cardiovasc Surg 2019; 157: 1100–1109.10.1016/j.jtcvs.2018.09.148CrossRefGoogle ScholarPubMed
Ochi, M.Review: Surgical Treatment of Giant Coronary Aneurysms in Pediatric Patients with Kawasaki Disease. Gen Thorac Cardiovasc Surg 2018; 66: 121–129.10.1007/s11748-017-0877-7CrossRefGoogle ScholarPubMed
Scohy, TV, Gommers, D, Jan ten Harkel, AD, et al.Intraoperative Evaluation of Micromultiplane Transesophageal Echocardiographic Probe in Surgery for Congenital Heart Disease. Eur J Echocardiogr 2007; 8: 241–246.10.1016/j.euje.2007.02.011CrossRefGoogle ScholarPubMed
Pavithran, S, Natarajan, K, Vishwambaran, B, Arke, AD, Sivakumar, K.Preliminary Evaluation of a Microtransesophageal Probe in Neonates and Young Infants Undergoing Surgery for Congenital Heart Disease. Ann Pediatr Cardiol 2014; 7: 173–179.Google Scholar
Lang, RM, Badano, LP, Tsang, W, et al.Eae/Ase Recommendations for Image Acquisition and Display Using Three-Dimensional Echocardiography. J Am Soc Echocardiogr 2012; 25: 3–46.10.1016/j.echo.2011.11.010CrossRefGoogle ScholarPubMed
Wong, D, Golding, F, Hess, L, et al.Intraoperative Coronary Artery Pulse Doppler Patterns in Patients with Complete Transposition of the Great Arteries Undergoing the Arterial Switch Operation. Am Heart J 2008; 156: 466–472.10.1016/j.ahj.2008.05.009CrossRefGoogle ScholarPubMed
Yamagishi, M, Yasu, T, Ohara, K, Kuro, M, Miyatake, K.Detection of Coronary Blood Flow Associated with Left Main Coronary Artery Stenosis by Transesophageal Doppler Color Flow Echocardiography. J Am Coll Cardiol 1991; 17: 87–93.10.1016/0735-1097(91)90708-HCrossRefGoogle ScholarPubMed
Arnaiz, E, Koolbergen, D, Adsuar, A, Hazekamp, MG.Surgery for Supravalvular Aortic Stenosis – the Three-Patch Technique. Multimed Man Cardiothorac Surg 2008; 2008: mmcts 2006 002329.Google ScholarPubMed
Koh, TW, Ferdinand, FD, Jin, XY, Gibson, DG, Pepper, JR.Coronary Artery Problems During Homograft Aortic Valve Replacement: Role of Transesophageal Echocardiography. Ann Thorac Surg 1997; 64: 533–535.10.1016/S0003-4975(97)00528-6CrossRefGoogle ScholarPubMed
Delgado, V, Ng, AC, Shanks, M, et al.Transcatheter Aortic Valve Implantation: Role of Multimodality Cardiac Imaging. Expert Rev Cardiovasc Ther 2010; 8: 113–123.10.1586/erc.09.135CrossRefGoogle ScholarPubMed
Savage, RM, Lytle, BW, Aronson, S, et al.Intraoperative Echocardiography Is Indicated in High-Risk Coronary Artery Bypass Grafting. Ann Thorac Surg 1997; 64: 368–373; discussion 73–4.10.1016/S0003-4975(97)00612-7CrossRefGoogle ScholarPubMed
Guarracino, F, Cariello, C, Tritapepe, L, et al.Transoesophageal Echocardiography During Coronary Artery Bypass Procedures: Impact on Surgical Planning. HSR Proc Intensive Care Cardiovasc Anesth 2010; 2: 43–49.Google ScholarPubMed
Sung, SC, Chang, YH, Lee, HD, et al.Arterial Switch Operation for Transposition of the Great Arteries with Coronary Arteries from a Single Aortic Sinus. Ann Thorac Surg 2005; 80: 636–641.10.1016/j.athoracsur.2005.02.042CrossRefGoogle ScholarPubMed
Kirklin, JW, Blackstone, EH, Tchervenkov, CI, Castaneda, AR.Clinical Outcomes after the Arterial Switch Operation for Transposition. Patient, Support, Procedural, and Institutional Risk Factors. Congenital Heart Surgeons Society. Circulation 1992; 86: 1501–1515.10.1161/01.CIR.86.5.1501CrossRefGoogle ScholarPubMed
Khairy, P, Clair, M, Fernandes, SM, et al.Cardiovascular Outcomes after the Arterial Switch Operation for D-Transposition of the Great Arteries. Circulation 2013; 127: 331–339.10.1161/CIRCULATIONAHA.112.135046CrossRefGoogle ScholarPubMed
Tardif, JC, Vannan, MA, Taylor, K, Schwartz, SL, Pandian, NG.Delineation of Extended Lengths of Coronary Arteries by Multiplane Transesophageal Echocardiography. J Am Coll Cardiol 1994; 24: 909–919.10.1016/0735-1097(94)90849-4CrossRefGoogle ScholarPubMed
Xing, YQ, Khabbaz, KR, Karia, D, et al.Intraoperative Epicardial Coronary Artery Imaging: Rationale, Methods, and Applications. Echocardiography 2002; 19: 735–741.10.1046/j.1540-8175.2002.00735.xCrossRefGoogle ScholarPubMed
Arruda, AM, Dearani, JA, Click, RL, Ishikura, F, Seward, JB.Intraoperative Application of Power Doppler Imaging: Visualization of Myocardial Perfusion after Anastomosis of Left Internal Thoracic Artery to Left Anterior Descending Coronary Artery. J Am Soc Echocardiogr 1999; 12: 650–654.10.1053/je.1999.v12.a99349CrossRefGoogle ScholarPubMed
Fernandes, F, Alam, M, Smith, S, Khaja, F.The Role of Transesophageal Echocardiography in Identifying Anomalous Coronary Arteries. Circulation 1993; 88: 2532–2540.10.1161/01.CIR.88.6.2532CrossRefGoogle ScholarPubMed
Kasprzak, JD, Kratochwil, D, Peruga, JZ, et al.Coronary Anomalies Diagnosed with Transesophageal Echocardiography: Complementary Clinical Value in Adults. Int J Card Imaging 1998; 14: 89–95.10.1023/A:1006093401010CrossRefGoogle ScholarPubMed
Chigurupati, K, Sukesan, S, Lovhale, PS, Dharan, BS, Koshy, T.Comprehensive Intraoperative Transesophageal Echocardiography of Anomalous Left Coronary Artery from Pulmonary Artery: What to Look for and Where to Look? Echocardiography 2018; 35: 391–395.10.1111/echo.13798CrossRefGoogle ScholarPubMed
Supplementary material: File

Yim et al. supplementary material

Yim et al. supplementary material

Download Yim et al. supplementary material(File)
File 13.1 MB