Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T14:35:19.707Z Has data issue: false hasContentIssue false
  • English
  • Français

The use of intraoperative epicardial echocardiography with color flow imaging during the repair of complete atrioventricular septal defects

Published online by Cambridge University Press:  19 August 2008

Ross M. Ungerleider
Ross M. Ungerleider*
Affiliation:
Department of Surgery, Duke University Medical Center, Durham
*
Dr. Ross M. Ungerleider, Chief, Pediatric Cardiac Surgery, Box 3178, Duke University Medical Center, Durham, North Carolina 27710USA
Get access Rights & Permissions [Opens in a new window]

Abstract

The use of intraoperative echocardiography with Doppler color flow imaging has acquired increased popularity for early assessment of efficacy of repair of congenital heart defects soon after discontinuance of cardiopulmonary bypass. This technology has been found useful also for evaluating the anatomy of the lesion prior to repair. Furthermore, with the use of color flow mapping, additional anomalies, such as patent arterial duct or multiple ventricular septal defects, which might have been overlooked during the initial examination, can be easily diagnosed. Moreover, intraoperative echocardiography provides the quickest and most sensitive method for a surgeon to look for residual atrioventricular valves regurgitation and/or residual atrial or ventricular septal defects as well as for depressed ventricular contractility. Previous studies1–4 have discussed specifically the applicability of intraoperative color flow imaging during the repair of atrioventricular septal defect with a common atrioventricular orifice using both epicardial and transesophageal methodology. Routine intraoperative echocardiography with Doppler color flow imaging has been used since March 1987 at Duke University Medical Center during repair of congenital heart defects. Our aim was to confirm the preoperative dignosis and to assess the quality of repair soon after discontinuance of cardiopulmonary bypass. Our overall experience now includes 612 patients of whom 239 or 39% were less than one year of age at the time of repair. This indicates our tendency to undertake early correction regardless of the age of patients and of the severity of the lesion.

Type
Original Articles
Information
Cardiology in the Young , Volume 2 , Issue 1 , January 1992 , pp. 56 - 64
Copyright
Copyright © Cambridge University Press 1992

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.Ungerleider, RM, Kisslo, JA, Greeley, WJ, Van Trigt, P, Sabiston, DC Jr. Intraoperative prebypass and postbypass epicardial color flow imaging in the repair of atrioventricular septal defects. J Thorac Cardiovasc Surg 1989; 98: 90–100.CrossRefGoogle ScholarPubMed
2.Canter, CE, Sekarski, DC, Martin, TC, Guitiérrez, FR, Spray, TL. Intraoperative evaluation of atrioventricular septal defect repair by color flow mapping echocardiography. Ann Thorac Surg 1989; 48: 544–550.CrossRefGoogle ScholarPubMed
3.Muhiudeen, IA, Roberson, DA, Silverman, NH, Haas, G, Turley, K, Cahalan, MK. Intraoperative echocardiography in infants and children with congenital cardiac shunt lesions: transesophageal versus epicardial echocardiography. J Am Coll Cardiol 1990; 16: 1687–1695.Google Scholar
4.Sreeram, N, Stumper, OF, Kaulitz, R, Hess, J, Roelandt, JR, Sutherland, GR. Comparative value of transthoracic and transesophageal echocardiography in the assessment of congenital abnormalities of the atrioventricular junction. J Am Coll Cardiol 1990; 16: 1205–1214.CrossRefGoogle ScholarPubMed
5.Ungerleider, RM. The use of intraoperative echocardiography with Doppler color flow imaging in the repair of congenital heart defects. Echocardiography 1990; 7: 289–304.Google Scholar
6.Ungerleider, RM, Greeley, WJ, Sheikh, KH, Kern, FH, Kisslo, JA, Sabiston, DC Jr. The use of intraoperative echo with Doppler color flow imaging to predict outcome after repair of congenital cardiac defects. Ann Surg 1989; 210: 526–534.CrossRefGoogle ScholarPubMed
7.Ungerleider, RM, Greeley, WJ, Sheikh, KH, Philips, J, Pearce, FB, Kern, FH, Kisslo, JA. Routine use of intraoperative epicar-dial echocardiography and Doppler color flow imaging to guide and evaluate repair of congenital heart lesions. A prospective study. J Thorac Cardiovasc Surg 1990; 100: 297–309.CrossRefGoogle ScholarPubMed
8.Stumper, OF, Elzenga, NJ, Hess, J, Sutherland, GR. Transesopha-geal echocardiography in children with congenital heart disease: an initial experience. J Am Coll Cardiol 1990; 16: 433–441.Google Scholar
9.Kyo, S, Omoto, R, Matsumura, M, Shah, P, Ito, H. Intraoperative transesophageal echocardiography in pediatric patients. J Thorac Cardiovasc Surg 1990; 99: 373–375. [Letter]Google Scholar
10.Greeley, WJ, Ungerleider, RM, Kern, FH, Kisslo, JA. Intramyocardial air causes right ventricular dysfunction after repair of congenital heart defects. Anesthesiology 1990; 73: 1042–1046.CrossRefGoogle Scholar
11.Ungerleider, RM. Epicardial echocardiography during repair of congenital heart defects. Advances in Cardiac Surgery 1991; pp 67–74.Google Scholar
12.Weintraub, RG, Brawn, WJ, Venables, AW, Mee, RBB. Two-patch repair of complete atrioventricular septal defect in the first year of life. J Thorac Cardiovasc Surg 1990; 99: 320–326.CrossRefGoogle ScholarPubMed
13.Chang, Chung-I, Becker, AE. Surgical anatomy of left ventricular outflow tract obstruction in complete atrioventricular septal defect. A concept for operative repair. J Cardiovasc Surg 1987; 94: 897–903.Google ScholarPubMed
14.Ebels, T, Ho, SY, Anderson, RH, Meijboom, EJ, Eijgelaar, A. The surgical anatomy of the left ventricular outflow tract in atrioventricular septal defect. Ann Thorac Surg 1986; 41: 483–488.CrossRefGoogle ScholarPubMed