Predictive value of intraoperative transesophageal echocardiography in complete atrioventricular septal defect.
BACKGROUND
Intraoperative transesophageal echocardiography and follow-up transthoracic echocardiography have been useful in assessing cardiac function in complete atrioventricular septal defects. However, it has been suggested that a discrepancy exists between intraoperative and postoperative findings, and that intraoperative findings cannot reliably predict long-term results. This study aims to determine whether this discrepancy exists and to assess whether it is possible to predict follow-up results using intraoperative transesophageal echocardiography.


METHODS
A retrospective analysis was made in 35 patients who underwent biventricular repair by one surgeon between November 1997 and January 2004. All patients received intraoperative transesophageal echocardiography and follow-up transthoracic echocardiography at 19.1 +/- 18.02 months (range, 7 days to 5 years; median, 15.1 months).


RESULTS
In left-sided atrioventricular valve regurgitation, 34.3% (12 of 35) of patients showed discrepancy during follow-up, and 28.6% (10 of 35) showed progression of regurgitation (from grade I to II). In right-sided atrioventricular valve, 11.4% (4 of 35) of patients showed discrepancy, 9.6% (3 of 35) showed progression of regurgitation (from grade I to II).


CONCLUSIONS
In complete atrioventricular septal defects, intraoperative transesophageal echocardiography did not show the same findings as that of follow-up transthoracic echocardiography in some cases. However, this discrepancy is not so great as to require reoperation in early to midterm follow-up. Therefore, intraoperative transesophageal echocardiography may be used as tool to predict durability of surgical results and to decrease the incidence of reoperation in complete atrioventricular septal defects.
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon, Korea.
Hyun Koo
HK
Kim
Woong-Han
WH
Kim
Sung Wook
SW
Hwang
Jae Young
JY
Lee
Jin Young
JY
Song
Soo-Jin
SJ
Kim
Ki Young
KY
Jang
D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006343:Heart Septal Defects / Q000150:complications / Q000601:surgery*; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D008297:Male; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016896:Treatment Outcome