Intraoperative epicardial echocardiography: early experience with a newly developed small surgical transducer

To test the feasibility of performing intraoperative echocardiography with a specially designed epicardial transducer, 20 adult patients were studied. All patients were undergoing coronary bypass surgery and had structurally normal intracardiac anatomy. The surgical transducer has 48 elements and a size at the tip of 10 x 12 x 5 mm. The scan plane has been set at 90 degrees to the cable axis to allow scanning from lateral positions. The terminal 10 cm of the cable has been reinforced to act as a malleable and steerable handle. Good quality images were obtained with the new transducer, and many different imaging planes were identified compared to imaging with the standard transducers. These include the right ventricular apex, the right and left lateral aspects of the heart, the aortic arch, and the pulmonary artery and its branches. The limitation of the probe was the difficulty in obtaining left ventricular apical views because of ventricular arrhythmias sustained when the transducer was placed between the left ventricular apex and the diaphragm. We conclude that this new transducer has a promising future in the application of intraoperative epicardial echocardiography.