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

• 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
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2023.02.031

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.