Role of early postoperative surface echocardiography in the pediatric cardiac intensive care unit.
OBJECTIVE
To compare surface echocardiographic data with catheterization and surgical observation as a way of deciding on the need to reoperate to correct hemodynamically important sequelae following pediatric cardiac surgery; to determine the false-negative diagnosis rate of surface echocardiography.


METHODS
Case series.


METHODS
Tertiary-care center, pediatric cardiac intensive care unit.


METHODS
All 39 patients who underwent reoperation because of hemodynamically significant anatomic sequelae following primary or elective secondary surgery in 1 calendar year.


METHODS
None.


METHODS
Two-dimensional and color Doppler ultrasound assessment of anatomy and physiology following cardiac surgery.


RESULTS
In 85 percent, surface echocardiography provided sufficient information for surgeons to reoperate on the same admission. Detection of important residual shunts or arterial stenoses and identification of anatomic causes of pulmonary undercirculation (or overcirculation) in palliated single ventricle are feasible.


CONCLUSIONS
Early postoperative surface echocardiography is a viable way to decide on the hemodynamic adequacy of cardiac surgery.
Chin
A J
AJ
Cardiac Noninvasive Laboratories, Children's Hospital of Philadelphia 19104.
Vetter
J M
JM
Seliem
M
M
Jones
A A
AA
Andrews
B A
BA
D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004452:Echocardiography; D015150:Echocardiography, Doppler; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery*; D006343:Heart Septal Defects / Q000000981:diagnostic imaging / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D010166:Palliative Care; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery; D011652:Pulmonary Circulation; D012086:Reoperation; D012680:Sensitivity and Specificity; D014654:Vascular Patency