Transesophageal Echocardiography During Interventional Catheterization in Congenital Heart Disease

The rapidly expanding role of transesophageal echocardiography (TEE) in the management and treatment of congenital heart disease includes guidance of interventional cardiac catheterization procedures and monitoring of results. TEE is particularly helpful for assessing device position during device closure of atrial septal defects (ASD), ventricular septal defects, and perivalvar defects, especially when multiple or complex defects are present. It is also useful during balloon dilation of certain congenital and postoperative obstructions. Stent placement for treatment of intracardiac obstructions is facilitated by TEE guidance. The risks associated with Brockenbrough transseptal puncture and ASD enlargement, particularly in the setting of unusual atrial anatomy, may be reduced by TEE guidance of the procedure. TEE monitoring of video assisted thoracoscopic closure of patent ductus arteriousus has contributed to the high success rate of this innovative procedure. TEE imaging assists in positioning of devices and catheters, reduces radiation exposure and contrast load, and provides immediate and continuous assessment not only of results, but of potential complications of interventional procedures. As the applications of interventional catheterization in the field of pediatric cardiology increase so will the role of TEE.