title: Safety and efficiency of the new micro-multiplane transoesophageal probe in paediatric cardiology.
abstract: BACKGROUND
  Transoesophageal echocardiography (TOE) is feasible in neonates using a miniaturized probe, but is not widely used because of low imaging quality.
  
  
  OBJECTIVE
  To assess handling and imaging quality of a new release of a micro-TOE probe in children.
  
  
  METHODS
  Thirty-eight consecutive children, enrolled during February and May 2013, underwent TOE with the Philips S8-3t probe. Insertion, handling and image quality were assessed.
  
  
  RESULTS
  The 38 children (aged 7days to 12years; weight 3.1-27kg) underwent 75 TOE (30 [40.0%] before cardiac surgery, 31 [41.3%] after cardiac surgery, 4 [5.3%] during a percutaneous procedure, 10 [13.3%] in the intensive care unit). Insertion of the micro-TOE probe was 'very easy' in 37/38 patients (97.4%). Handling was better in the lightest children (P=0.001). Image quality was mainly 'good' or 'very good', with no significant changes between preoperative and postoperative examinations or over time. Total scores (insertion, handling, image quality) were significantly better in the lightest children (P=0.02). Preoperative TOE did not provide additional information over transthoracic echocardiography. Postoperative TOE was useful to assess surgical results, but no residual lesions required extracorporeal circulation return. Micro-TOE was useful during the postoperative care of neonatal surgery with open breastbone to assess the surgical result and ventricular function. It was also useful to guide extracorporeal membrane oxygenation (ECMO) indication and withdrawal; and was a useful guide for percutaneous procedures.
  
  
  CONCLUSIONS
  Micro-multiplane TOE is safe and efficient for use in neonates and children. This minimally invasive tool increases the impact of TOE in paediatric cardiology.
authors.affiliation: Paediatric Cardiology Unit, Children Hospital, Toulouse University Hospital, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Hascoët
authors.affiliation: Paediatric Cardiology Unit, Children Hospital, Toulouse University Hospital, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Peyre
authors.affiliation: Paediatric Cardiology Unit, Children Hospital, Toulouse University Hospital, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
authors.forename: Khaled
authors.initials: K
authors.lastname: Hadeed
authors.affiliation: Department of Anesthesiology, Children Hospital, Toulouse University Hospital, 31059 Toulouse cedex 9, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Alacoque
authors.affiliation: Department of Anesthesiology, Children Hospital, Toulouse University Hospital, 31059 Toulouse cedex 9, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Chausseray
authors.affiliation: Department of Anesthesiology, Children Hospital, Toulouse University Hospital, 31059 Toulouse cedex 9, France.
authors.forename: Rose
authors.initials: R
authors.lastname: Fesseau
authors.affiliation: Paediatric Cardiology Unit, Children Hospital, Toulouse University Hospital, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Amadieu
authors.affiliation: Department of Congenital Heart Disease Surgery, Children Hospital, Toulouse University Hospital, 31059 Toulouse cedex 9, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Léobon
authors.affiliation: Department of Paediatric Intensive Care Unit, Children Hospital, Toulouse University Hospital, 31059 Toulouse cedex 9, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Berthomieu
authors.affiliation: Paediatric Cardiology Unit, Children Hospital, Toulouse University Hospital, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Dulac
authors.affiliation: Paediatric Cardiology Unit, Children Hospital, Toulouse University Hospital, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. Electronic address: acar.p@chu-toulouse.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Acar
mesh_terms: D000367:Age Factors; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D018618:Echocardiography, Doppler, Color / Q000009:adverse effects / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D008904:Miniaturization; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors
keywords: Cardiopathie congénitale; Children; Congenital heart disease; Enfants; Micro-multiplan ETO; Neonates; Nouveau-nés; Paediatric cardiology; Transoesophageal echocardiography; Échographie transœsophagienne