[Transesophageal echocardiography--is it indicated for children undergoing heart surgery?]

In adults transesophageal echocardiography (TEE) has become a well-established method for the assessment of cardiac malformations. In children the transthoracic approach (TTE) gives excellent resolution and cardiac malformations can be well defined in most of the cases. Uncertainty may, nevertheless, exist in complex anomalies in spite of TTE and angiography or after surgical interventions. Recently pediatric 5-mHz TEE probes have been developed with acceptable diameters of 6, 9 and 11 mm. The feasibility and the potential risks of TEE were studied in 47 patients, aged from 5 months to 16 years (mean 5 9/12 years), weighing from 5 to 47 kg (mean 19.7 kg). 35 children had congenital malformations: 15 VSD + PS, 5 VSD + PHT, 3 ASD, 5 A-V canal malformations, 1 tricuspid atresia, 2 subvalvar aortic stenosis, 3 endocarditis, 1 normal. Twelve children had rheumatic heart disease. Eight patients had more than 1 TEE. The examination was performed either under general anaesthesia just before of after surgical intervention in 32 or under sedation and with local anaesthesia in the others. There was no complication, but in 3 intubated children under 3 years of age TEE was not possible; obstruction of the endotracheal tube occurred. Adequate imaging was obtained in most of the children with one or the other probe. Additional information was obtained in 28 patients (52%). In 5 of them these informations modified the surgical procedure. We conclude that TEE is feasible in children and has a low risk of complications when practised with care.(ABSTRACT TRUNCATED AT 250 WORDS)