A RETROSPECTIVE REVIEW OF THE ROLE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN AORTIC AND CARDIAC TRAUMA IN A LEVEL-I PEDIATRIC TRAUMA CENTER

This study examined the role of transesophageal echocardiography in bl unt aortic and cardiac trauma in a Pediatric Level I Trauma Center. In a >5-year retrospective review, we identified 10 children with blunt cardiac (n = 4; tricuspid valve in two; mitral valve in one; aortic va lve in one) and aortic (n = 6; aortic rupture in five, subintimal flap in one) trauma. Diagnosis of the cardiac injuries was made with trans thoracic echocardiography, with transesophageal echocardiography provi ding additional anatomic detail and postoperative assessment in three of four children who required surgical intervention. Diagnosis of the aortic injuries was made with transesophageal echocardiography in five of six patients; one patient underwent aortography before transfer. T ransesophageal echocardiography also identified depressed myocardial f unction in one child and aided in surgical management of the five aort ic ruptures. In blunt chest trauma, transesophageal echocardiography p rovides accurate evaluation of cardiovascular structure and function a nd guides operative repair.