USEFULNESS OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE PEDIATRIC CATHETERIZATION LABORATORY

Transesophageal echocardiography was performed in 51 children (aged 2 to 14 years, mean 4; weight 9 to 50 kg, mean 21) undergoing elective d iagnostic or therapeutic cardiac catheterization. The interventional p rocedures were percutaneous balloon dilation of pulmonary (n = 8) and aortic (n = 2) valve stenosis, percutaneous closure of patent ductus a rteriosus (n = 8), and attempted occlusion of Pott's anastomosis by th e double umbrella device (n = 1). The diagnostic catheterizations were performed on preoperative children of whom 5 had undergone previous p alliative procedures. Precise placement of the balloon across the valv e, timing of balloon inflation and deflation according to real-time mo nitoring of ventricular function and immediate evaluation of results a nd complications were accomplished with transesophageal monitoring. Th e exact position of distal and proximal umbrellas of patent ductus occ lusive devices was checked on transesophageal imaging and completeness of occlusion controlled on color Doppler. The only relevant informati on in the preoperative cases was the detection of a septic thrombus in a severely ill patient. With more experience and smaller probes, tran sesophageal echocardiography may become a new method of monitoring car diac catheterization also in smaller children where it may reduce dura tion of the procedure and amount of contrast material.