Indispensable Role of Transesophageal Echocardiography in Double-Chamber Right Ventricle Repair Surgery

Double-chamber right ventricle repair surgery requires the excision of anomalous obstructive muscular or fibromuscular bundles in the right ventricular outflow tract. Because of the close proximity of key structures in the right ventricular outflow tract, the surgery is extremely challenging and req...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2023-07, Vol.37 (7), p.1321-1323
Main Authors: Narula, Jitin, Bansal, Piyush, Rajput, Nitin
Format: Article
Language:English
Subjects:
pediatric cardiac surgery
pulmonary regurgitation
pulmonary valve injury
transesophageal echocardiography
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Summary:Double-chamber right ventricle repair surgery requires the excision of anomalous obstructive muscular or fibromuscular bundles in the right ventricular outflow tract. Because of the close proximity of key structures in the right ventricular outflow tract, the surgery is extremely challenging and requires precise resection. Underresection of the muscle bands can lead to significant residual gradients in the postoperative period, whereas overenthusiastic resection can cause iatrogenic injury to surrounding structures. Various techniques like Hegar sizing by the surgeons, direct chamber pressure measurement, transesophageal echocardiography, and epicardial echocardiography can guide the surgeons about the adequacy of repair. Transesophageal echocardiography is crucial at each step, as it can precisely determine the exact site of obstruction in the preoperative period. Postoperatively, it helps determine the adequacy of surgical repair and identification of inadvertent iatrogenic complications.
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2023.02.031