Pediatric biplane transesophageal echocardiography: preliminary experience

Area of Science:

• Pediatric Cardiology
• Medical Imaging
• Echocardiography

Background:

• Biplane transesophageal echocardiography (TEE) has been limited in neonates.
• Recent development of pediatric biplane TEE transducers enables its use in this population.
• Complex congenital heart disease requires advanced imaging techniques.

Purpose of the Study:

• To evaluate the feasibility and utility of a prototype pediatric biplane TEE probe.
• To assess the success rate, complications, and added diagnostic value of the vertical plane in neonates and children undergoing cardiac surgery.
• To determine the impact of biplane TEE on imaging complex congenital heart disease.

Main Methods:

• Perioperative use of a 64-element pediatric biplane TEE probe in 46 infants and children (2.9-32 kg) with complex congenital heart disease.
• Assessment of probe insertion success, procedural complications, and image quality.
• Quantification of additional information provided by the vertical plane compared to the horizontal plane.

Main Results:

• Successful probe insertion in all patients.
• Imaging was discontinued in one neonate due to potential airway compression; excellent image quality in the remaining 45.
• The vertical plane provided additional diagnostic information in 58% (44%) of identified anomalies.
• The vertical plane was particularly beneficial for assessing ventricular outflow tract abnormalities.

Conclusions:

• Pediatric biplane TEE is a safe and effective imaging modality for neonates and children with complex congenital heart disease.
• The vertical plane significantly enhances diagnostic capabilities, especially for ventricular outflow tract anomalies.
• Biplane TEE extends the application of TEE imaging to the youngest pediatric cardiac surgical patients.