Transesophageal echocardiography in children with cardiac assist.
Transesophageal echocardiography (TEE) is an easy, relatively non-invasive method for evaluation of cardiac function and abnormalities during cardiac assist. We used 19 TEE in 9 children (age: 10 days-4 years, weight: 2.7-12 kg) with mechanically assisted circulation for postcardiotomy cardiogenic shock. TEE provided valuable information: (1) dislocation of the cannula causing hemodynamic instability could be easily diagnosed and corrected; (2) Doppler evaluation of valvular function revealed severe malfunction in two patients; (3) intracardiac thrombus could be clearly detected in two children with seriously impaired hemodynamics. These findings were followed by therapeutic interventions; (4) left-ventricular function before attempted weaning from cardiac assist was moderately reduced or normal in the survivors, but poor in the nonsurvivors. We conclude that TEE is a valuable contribution to improved patient management during cardiac assist.
Kececioglu
D
D
Department of Pediatric Cardiology, Westphalian Wilhelms Universität, Münster, Germany.
Galal
O
O
Halees
Z
Z
Fadely
F
F
Wilson
N
N
Vogt
J
J
D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000503:physiopathology