While advances in cardiac surgery and interventions have improved outcomes for complete repair of complex congenital abnormalities on small infants, residual defects remain a challenge. In fact, studies have shown that patients who leave the procedure room with significant residual defects have increased morbidity and mortality.1,2
Post-procedural assessment using transesophageal echo can help identify residual defects in need of repair while the patient is still in-suite.1,2,3
However, because there were no multiplane TEE options for patients weighing less than 3.5 kg, physicians have often used single-plane or offlabel imaging methods to get echo assessments on these tiny patients, or have been forced to forego post-procedural echo altogether.
A light in the dark for tiny patients
To bring the light of imaging to these very small patients, Philips has developed the microTEE,
a miniaturized multiplane transducer appropriate for use in patients below 3.5 kg. Supporting 2D, Doppler, color flow, harmonic imaging, M-mode, and 2D analysis, the microTEE joins the Live 3D TEE as exclusive tools from Philips for peri-procedural imaging for congenital and structural repairs.
“Our initial experience demonstrates that the microTEE provides high-quality, useful diagnostic images without hemodynamic or venitilatory compromise in small infants. We anticipate that the microTEE will play an important role in the continued progress of perioperative care for the small infants undergoing cardiac operations.”4
Study shows value of microTEE imaging assessment
Investigators from the Medical University of South Carolina and Children’s Hospital of Philadelphia recently conducted a study of 42 patients undergoing cardiac operations with a mean weight of 3.6 kg (range: 1.7 kg to 5 kg), in which they measured hemodynamic and ventilation variables before and after microTEE insertion and removal to assess the feasibility and value of using the transducer on these tiny patients. The microTEE transducer was used successfully to image 100% of the patients, with no complications or clinically significant changes in hemodynamic or ventilation variables.4
Importantly, information from microTEE assessment during surgery resulted in surgical revision for 6 of the 42 patients.
+ Learn more about the iE33 xMATRIX system
+ Learn more about microTEE
+ See microTEE images on the iE33
+ Learn more about congenital heart disease
1. Ungerleider RM, Kisslo JA, Greeley WJ, et al. Intraoperative echocardiography during congenital heart operations: experience from 1,000 cases. Annals of Thoracic Surgery 1995; 60: S539 – 42.
2. Rosenfeld, HM, Gentles TL, Wernovsky, G, et al. Utility of intraoperative transesophageal echocardiography in assessment of residual cardiac defects. Pediatric Cardiology 1998; 19:346 – 351
3. Randolph GR, Hagler DJ, Connolly HM, et al. Intraoperative transesophageal echocardiography during surgery for congenital heart defects. Journal of Thoracic Cardiovascular Surgery 2002;124:1176 – 82.
4. Zyblewski SC, Shirali G, Graham E, et al. Initial Experience With a Miniaturized Multiplane Transesophageal Probe in Small Infants Undergoing Cardiac Operations. Annals of Thoracic Surgery. 2010; 89:1990 – 4.