Transoesophageal echocardiography using the miniaturised multiplane probe during paediatric cardiac intervention in children below 5.5 kg – an initial experience

Introduction Until recently intra-operative transesophageal echocardiography (TOE) has not been feasible in neonates and small infants. TOE is routinely used intra-operatively at our institution in children >5.0 kg, below this weight epicardial echocardiography is used. Earlier surgery that includes repair of complex congenital heart disease is increasingly frequent. Aims To ascertain whether a newly available micro-TOE probe is beneficial and safe in the treatment of small infants. Methods We assessed our experience of a new miniaturised multiplane micro-TOE probe (Phillips Medical Systems) in small infants below 5.5 kg undergoing cardiac intervention. Results 21 patients, 11 male (median age 112 days, range 3–214 days), median weight 4.4 kg range 3.0–5.4 kg) underwent cardiac intervention with micro-TOE guidance. The type of intervention is summarised in table 1. Probe insertion was successful in all 21 patients. No immediate haemodynamic or clinical complications related to probe insertion or removal occurred. Diagnostic images were possible in all cases (figure 1). There was a learning curve with more structures identified in the later part of the study, in particular coronary arteries. Conclusions Infants under 5.5 kg having cardiac intervention were able to undergo intra-operative micro-TOE without complication. These patients need no longer be excluded from advanced high quality intra-operative imaging during cardiac surgery.