Endoscopic evaluation of the esophagus in infants and children immediatelyfollowing intraoperative use of transesophageal echocardiography

Objective: Intraoperative transesophageal echocardiography (TEE) has evolve d as an essential technique for use during pediatric cardiac surgery; howev er, few studies have evaluated the safety of TEE in children. This series r eports endoscopic examination of the esophagus following intraoperative TEE in pediatric patients. Methods: Fifty children undergoing congenital heart surgery underwent flexi ble esophagoscopy that was performed after completion of their heart surger y and after the removal of the transesophageal echo probe. The patients' ag es ranged from 4 days to 10 years old, and their weight ranged from 3.0 to 39.8 kg, with a mean weight of 12.6 kg. Results: Thirty-two of 50 patients (64%) had abnormal results shown on esop hageal examinations; this occurred more frequently in the subset of patient s weighing < 9 kg. No long-term feeding or swallowing difficulties were not ed in any of the 48 patients who survived. Conclusions: Intraoperative TEE in infants and children frequently caused m ild mucosal injury. Care must be exercised in the insertion and manipulatio n of the probes.