The role of transoesophageal echocardiography in adolescents and adults with congenital heart defects

Between April 1985 and December 1989, outpatient transoesophageal echocardiography was performed in 133 adolescent and adult patients (14% of all outpatient transoesophageal studies) (age range 11–78 years; weight 30–95 kg) to determine the value of this technique both in establishing the primary di...

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Bibliographic Details
Published in:European heart journal 1991-02, Vol.12 (2), p.231-240
Main Authors: SREERAM, N., SUTHERLAND, G. R., GEUSKENS, R., STÖMPER, O. F. W., TAAMS, M., GUSSENHOVEN, E. J., HESS, J., ROELANDT, J. R. T. C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Blood Flow Velocity - physiology
Cardiology. Vascular system
Child
congenital
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
echocardiography
Echocardiography - instrumentation
Echocardiography, Doppler - instrumentation
Female
Follow-Up Studies
Heart
Heart defects
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - surgery
Humans
Image Processing, Computer-Assisted - instrumentation
Male
Medical sciences
Middle Aged
Postoperative Complications - diagnostic imaging
Transducers
transoesophageal
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Summary:Between April 1985 and December 1989, outpatient transoesophageal echocardiography was performed in 133 adolescent and adult patients (14% of all outpatient transoesophageal studies) (age range 11–78 years; weight 30–95 kg) to determine the value of this technique both in establishing the primary diagnosis (62 patients) and in the post-surgical follow up (71 patients) of congenital heart disease. The results were correlated with the findings of precordial echocardiography, catheterization and surgical inspection. Clear advantages of transoesophageal imaging over precordial imaging include: (1) direct identification of atrial appendage morphology in all patients; (2) delineation of systemic and pulmonary venous connections; (3) atrial baffle function (eight patients); (4) better evaluation of the Fontan-type circulation (five patients); (5) improved morphologic assessment of the atrioventricular junction and valves (29 patients); (6) definition ofsubaortic obstruction (18 patients); and (7) definition of ascending aortic morphology in Marfan's syndrome and supravalvar aortic stenosis (13 patients). The problems encountered with transoesophageal imaging include: (1) limited imaging planes; (2) poor visualization of specific intracardiac regions (antero-apical trabecular septum, right ventricular outflow tract); (3) flow masking behind implanted intracardiac prosthetic material.
ISSN:0195-668X
1522-9645
DOI:10.1093/oxfordjournals.eurheartj.a059874