Index

Transesophageal Echocardiography of Congenital Heart Diseases Poonam Malhotra Kapoor, Sarvesh Pal Singh

CHAPTER 1:Introduction to TEE for Congenital Heart Disease
- INTRODUCTION
- INDICATIONS FOR TEE IN PATIENTS WITH CONGENITAL HEART DISEASE
- TEE GUIDED INTERVENTIONS
- CONTRAINDICATIONS FOR THE USE OF TEE (TABLE 1)
  - Absolute
  - Relative
- DEFINITIONS
- SIGNIFICANCE
- IMAGING PLANES AND ORIENTATION
- GOALS OF THE EXAMINATION
- PROBE INSERTION
- PROBE MANIPULATION
  - Terminology of TEE Probe Manipulation
- ACHD: TRANSESOPHAGEAL ECHOCARDIOGRAPHIC IMAGING ALGORITHM
CHAPTER 2:Chambers, Valves and Normal Dimensions
- LEFT VENTRICULAR MEASUREMENTS (TABLE 2)
  - Common Pitfalls of LV
- RIGHT VENTRICULAR DIMENSIONS (TABLE 6)
  - Right Ventricular Function (Fig. 3)
- NADAS' CRITERIA
  - Assessment for Presence of Heart Disease in Children
    - Major Criteria
    - Minor Criteria
- REFERENCE VALUES FOR NORMAL ADULT TRANSESOPHAGEAL ECHOCARDIOGRAPHY MEASUREMENTS
CHAPTER 3:TEE Views in Congenital Heart Disease
- INTRODUCTION
- MIDESOPHAGEAL FOUR CHAMBER VIEW
  - Probe Manipulation
- MIDESOPHAGEAL TWO CHAMBER VIEW
  - Probe Manipulation
- MIDESOPHAGEAL BICOMMISSURAL VIEW
  - Probe Manipulation
- MIDESOPHAGEAL LONG-AXIS VIEW
  - Probe Manipulation
- MIDESOPHAGEAL AORTIC VALVE LONG-AXIS VIEW
  - Probe Manipulation
- MIDESOPHAGEAL AORTIC VALVE SHORT-AXIS VIEW
  - Probe Manipulation
- MIDESOPHAGEAL BICAVAL VIEW
  - Probe Manipulation
- MIDESOPHAGEAL DESCENDING THORACIC AORTA LONG-AXIS VIEW
  - Probe Manipulation
- MIDESOPHAGEAL DESCENDING THORACIC AORTA SHORT-AXIS VIEW
  - Probe Manipulation
- MIDESOPHAGEAL ASCENDING AORTA LONG-AXIS VIEW
  - Probe Manipulation
- MIDESOPHAGEAL ASCENDING AORTA SHORT-AXIS VIEW
  - Probe Manipulation
- MIDESOPHAGEAL LEFT ATRIAL APPENDAGE VIEW
  - Probe Manipulation
- MIDESOPHAGEAL MODIFIED BICAVAL VIEW
  - Probe Manipulation
- MIDESOPHAGEAL RIGHT PULMONARY VEIN VIEW
  - Probe Manipulation
- MIDESOPHAGEAL RIGHT VENTRICLE INFLOW-OUTFLOW VIEW
  - Probe Manipulation
- LOWER ESOPHAGEAL CORONARY SINUS VIEW
  - Probe Manipulation
- TRANSGASTRIC VIEWS
- PROBE MANIPULATION TO ACHIEVE TRANSGASTRIC VIEWS
- TRANSGASTRIC MODIFIED HEPATIC VEIN VIEW
  - Probe Manipulation
- TRANSGASTRIC TWO CHAMBER VIEW
  - Probe Manipulation
- TRANSGASTRIC APICAL SHORT-AXIS VIEW1
  - Probe Manipulation
- TRANSGASTRIC BASAL LONG-AXIS VIEW2
  - Probe Manipulation
- TRANSGASTRIC BASAL SHORT-AXIS VIEW
  - Probe Manipulation
- TRANSGASTRIC MID-PAPILLARY SHORT-AXIS VIEW
  - Probe Manipulation
- TRANSGASTRIC RIGHT VENTRICLE INFLOW-OUTFLOW VIEW
  - Probe Manipulation
- TRANSGASTRIC RIGHT VENTRICLE INFLOW VIEW
  - Probe Manipulation
- TRANSGASTRIC BASAL RIGHT VENTRICLE OUTFLOW VIEW1
- DEEP TRANSGASTRIC LONG-AXIS VIEW
  - Probe Manipulation
- UPPER ESOPHAGEAL AORTIC ARCH LONG-AXIS VIEW
  - Probe Manipulation
- UPPER ESOPHAGEAL AORTIC ARCH SHORT-AXIS VIEW
  - Probe Manipulation
- CONCLUSION
CHAPTER 4:TEE for Atrial Septal Defect
- DEFINITION
- PATHOPHYSIOLOGY (FIG. 2A)
- DIFFERENT TYPES OF ARTERIAL SEPTAL DISEASE (FIGS 2A AND B)
  - Ostium Secundum (Figs 3 and 4)
  - Ostium Primum (Table 1 and Flow chart 1)
  - Coronary Sinus (Unroofed) (Figs 5 and 6)
- CLINICAL SYMPTOMS OF ATRIAL SEPTAL DEFECT
  - Inspection
  - P2 Loud
  - Why There is a Click in Atrial Septal Defect?
- CLINICAL INVESTIGATIONS
  - X-ray Chest in Atrial Septal Defect (Figs 8A and B)
- ATRIAL SEPTAL DEFECT ECHOCARDIOGRAM
- GUIDELINES WHERE PREOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR ATRIAL SEPTAL DEFECT IS MUST
- PREOPERATIVE ASSESSMENT OF TEE (FIGS 10 TO 20)
- ATRIAL SEPTAL ANEURYSMS
- ROBOTIC ATRIAL SEPTAL DEFECT CLOSURE
- TEE FOR ASD DEVICE CLOSURE (FIGS 21 TO 24)
  - Precatheter Assessment
  - During Catheter Insertion
  - After Device Deployment
  - 3D TEE
- TEE FOR MINIMALLY INVASIVE ASD CLOSURE (FIGS 25 TO 28)
  - Right Thoracotomy (Fig. 29)
  - During Catheter/Cannula Placement (Table 2)
  - SVC Cannulation
    - Femoral Arterial Cannulation (Figs 32A and B)
  - Transfemoral IVC Cannulation (Figs 33A to C)
  - Monitoring during MICS ASD with TEE
  - TEE for Deairing and Weaning (Figs 33 to 36)
  - Check ECHO for ASD Repair in ME LAX View
- POSTDEVICE CLOSURE ASSESSMENT
- POSTOPERATIVE TEE ASSESSMENT
- TYPES OF 2° ASD AND DEVICE CLOSURE
  - After Surgical Closure of ASD, TEE is Performed to Confirm
- ADVANTAGES OF MINIMALLY INVASIVE CARDIAC SURGERY FOR ASD CLOSURE
- SPECTRUM OF MINIMALLY INVASIVE CARDIAC SURGERY
  - PTMC and ASD (Fig. 41)
- QUANTIFICATION OF 3D OVER 2D TEE (SEE FIGS 42 TO 65)
  - In Older Children
- SUMMARY
- FUTURE AND CONTROVERSIES
CHAPTER 5:TEE for Ventricular Septal Defect
- INTRODUCTION
- TYPES OF VSD
- CLINICAL FEATURES
- CLINICAL EXAMINATIONS
- CVS EXAMINATION
- ECG IN VENTRICULAR SEPTIC DEFECT
- X-RAY FINDINGS IN VENTRICULAR SEPTAL DEFECT (FIGS 3 AND 4)
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN VENTRICULAR SEPTAL DEFECT
- PREOPERATIVE TEE ASSESSMENT (FIGS 5 TO 21)
- POSTOPERATIVE TEE ASSESSMENT: USING SAME VIEWS AS FOR UNREPAIRED VSD (FIG. 22)
- TEE FOR VSD DEVICE CLOSURE (FIGS 23 TO 34)
- VENTRICULAR SEPTAL DEFECT COMPLICATIONS
- GERBODE VENTRICULAR SEPTAL DEFECT (FIGS 35 AND 36)
- CONCLUSION
CHAPTER 6:TEE for Atrioventricular Septal Defect
- INTRODUCTION
- CHEST X-RAY: PAV
  - Partial Atrioventricular Septal Defect
  - Complete Atrioventricular Septal Defect
- ECG (FIG. 3)
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY VIEWS
- PREOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY
- POSTOPERATIVE TEE ASSESSMENT
- FETAL ECHOCARDIOGRAM IN AVSD
- COMPLICATIONS
- LONG-TERM OUTCOME
CHAPTER 7:TEE for Pulmonary Stenosis
- INTRODUCTION
- PATHOPHYSIOLOGY OF PULMONARY STENOSIS
- BRANCH PERIPHERAL PULMONIC STENOSIS
- CAUSES AND CLINICAL PRESENTATION
- INFUNDIBULAR PULMONARY STENOSIS
- CLINICAL SIGNS OF PULMONARY STENOSIS
- PULMONARY ARTERY AND VEIN STENOSIS
  - TEE Findings in a Child with Pulmonary Vein Stenosis and Ventricular Septal Defect
- WHY IS PULMONARY STENOSIS A CONCERN?
- SEVERITY DEFINITIONS OF PULMONARY STENOSIS
- TETRALOGY OF FALLOT WITH INFECTIVE ENDOCARDITIS
- ETIOLOGY OF MPA ENDOCARDITIS
- TEE ASSESSMENT OF PULMONARY STENOSIS
  - Preoperative Assessment
  - Doppler Findings
- PERIOPERATIVE CARDIOPULMONARY BYPASS (2D ECHOCARDIOGRAPHY FINDINGS)
- POSTOPERATIVE PULMONARY STENOSIS ASSESSMENT (SEE FIGS 15 TO 17)
CHAPTER 8:TEE for Double-Chambered Right Ventricle
- INTRODUCTION
- NATURAL HISTORY OF DCRV
- ASSOCIATED ANOMALIES
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY VIEWS OF DCRV
  - TEE Views for DCRV
- ROLE OF ECHOCARDIOGRAPHY IN DIAGNOSING DOUBLE-CHAMBERED RIGHT VENTRICLE IN ADULTS
- PREOPERATIVE TEE ASSESSMENT
- ELECTROCARDIOGRAM OF DCRV
- POSTOPERATIVE TEE ASSESSMENT (FIGS 5 AND 6)
- CONCLUSION
CHAPTER 9:TEE for Patent Ductus Arteriosus
- INTRODUCTION
- CLINICAL FEATURES OF PATENT DUCTUS ARTERIOSUS
- X-RAY
- ECG
- ROLE OF TEE IN PDA
- TEE VIEWS FOR PATENT DUCTUS ARTERIOSUS: FOR SIMULTANEOUS COARCTATION OF AORTA TO BE RULED OUT
- PREOPERATIVE TEE ASSESSMENT
- POSTOPERATIVE TEE ASSESSMENT
- ROLE OF TEE IN PERCUTANEOUS DEVICE CLOSURE OF PDA
- ECHO ASSESSMENT FOLLOWING REPAIR USING THE SAME VIEWS AS FOR UNREPAIRED ASD
- CONCLUSION AND FUTURE DIRECTIONS
CHAPTER 10:TEE for Aortic Coarctation
- INTRODUCTION
- CLINICAL FEATURES OF AORTIC COARCTATION
- PHYSIOLOGY
- TRANSESOPHAGEAL ECHOCARDIOGRAPHIC EVALUATION
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY ASSESSMENT OF AORTIC COARCTATION
- MANAGEMENT OF AORTIC COARCTATION
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY ASSESSMENT FOLLOWING COARCTATION REPAIR
CHAPTER 11:TEE for Tetralogy of Fallot
- DEFINITION
- ETIOLOGY
- COMPONENTS OF TOF (FIG. 1)
- EMBRYOLOGY
- ASSOCIATED ANOMALIES IN TOF
- SYNDROMES ASSOCIATED WITH TOF
- CYANOTIC SPELLS IN TOF (FLOW CHART 1)
  - Cyanotic (Hypoxic) Spells
  - Treatment of Cyanotic Spells
- SQUATTING EPISODE
  - Mechanism
  - Equivalents for Squatting
- CLINICAL FEATURES IN TOF
- COMPLICATIONS
  - Definite Procedure
  - Important Points to Remember in TOF
- ANESTHESIA CONSIDERATION IN TOF
- 3D TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN TOF
- PREOPERATIVE TEE ASSESSMENT (FIGS 5A TO C)
- POSTOPERATIVE TEE ASSESSMENT (FIGS 6 TO 13)
- CONCLUSION
CHAPTER 12:TEE for Double-Outlet Right Ventricle
- INTRODUCTION
- DEFINITION
- VARIOUS CRITERIA FOR CLASSIFICATION OF DORV
  - Types of DORV
- OTHER ANOMALIES WITH DORV
- AORTIC OVER-RIDE
- CHEST X-RAY
- ELECTROCARDIOGRAPHY
- USE OF TEE IN DORV
- TWO-DIMENSIONAL TEE FOR DORV IN TOF (FIG. 5)
  - Anatomy and Suggested Two-Dimensional Views
    - Views for RVOT
  - Color Doppler
- VENTRICULAR SEPTAL DEFECT
- LOCATION OF VSD IN DORV
- PREOPERATIVE ASSESSMENT OF DORV ON TEE (FIG. 5)
- ASSESSMENT FOR ROUTABILITY OF VSD (FIG. 6)
- ANATOMY AND SUGGESTED TWO-DIMENSIONAL VIEWS FOR ROUTABILITY OF VENTRICULAR SEPTAL DEFECT
- POSTOPERATIVE ASSESSMENT OF DORV ON TEE (FIGS 7 TO 9)
- CONCLUSION
CHAPTER 13:TEE for Transposition of Great Arteries
- INTRODUCTION
- PREOPERATIVE TEE ASSESSMENT
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR SENNING PROCEDURE
- ASSESSMENT OF THE PULMONARY VENOUS PATHWAY
- ASSESSMENT OF SYSTEMIC VENOUS PATHWAY
- ASSESSMENT OF BAFFLE
- PERIOPERATIVE CARE, POST-SENNING OPERATION
- POSTOPERATIVE TEE ASSESSMENT (FIGS 6 TO 24)
- CONCLUSION
CHAPTER 14:TEE for Congenitally Corrected Transposition of Great Arteries
- INTRODUCTION
- CORRECTED TRANSPOSITION OF GREAT ARTERIES
- PREOPERATIVE TEE ASSESSMENT (FIGS 3 TO 19)
- POSTOPERATIVE TEE ASSESSMENT
- CONCLUSION
CHAPTER 15:TEE for Ebstein's Anomaly
- INTRODUCTION
- EMBRYOLOGY
- PATHOPHYSIOLOGY
- CLINICAL PRESENTATION IN EBSTEIN'S ANOMALY
- CLINICAL IMPLICATIONS
- ECG IN EBSTEIN'S ANOMALY
- X-RAY IN EBSTEIN'S ANOMALY (FIG. 5)
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR EBSTEIN'S ANOMALY
- ECHOCARDIOGRAPHY OF EBSTEIN'S ANOMALY
  - TEE Views for Evaluation of Ebstein's Anomaly
- PREOPERATIVE TEE ASSESSMENT: 2D AND 3D
  - Surgical Options for Ebstein's Anomaly
- POSTOPERATIVE TEE ASSESSMENT (FIGS 8 TO 11)
- KEY POINTS
CHAPTER 16:TEE for Double-Inlet Left Ventricle
- INTRODUCTION
- MORPHOLOGY
- VENTRICLES
- ASSOCIATED ANOMALIES WITH DILV
- PATHOPHYSIOLOGY/ NATURAL HISTORY OF DILV
- CLINICAL PRESENTATION
- TESTS TO DIAGNOSE DILV (TABLE 1)
- TRANSESOPHAGEAL ECHOCARDIOGRAPHY OF DILV (FIGS 2 TO 7)
CHAPTER 17:TEE for Univentricular Heart
- INTRODUCTION
- MORPHOLOGY (FIGS 1A AND B)
- ATRIOVENTRICULAR CONNECTIONS
- INCIDENCE AND SIGNIFICANCE
- UNIVENTRICULAR PHYSIOLOGY
- AORTOPULMONARY SHUNT
- BIDIRECTIONAL GLENN SHUNT
- TOTAL CAVOPULMONARY ANASTOMOSIS
- PREOPERATIVE ASSESSMENT (FIG. 2)
  - Pulmonary Anatomy (PA)
- OBSTRUCTION OF ANASTOMOSIS
  - TEE Detected
- ECHOCARDIOGRAPHY OF UNIVENTRICULAR HEART (FIGS 3 TO 11)
CHAPTER 18:TEE for Total Anomalous Pulmonary Venous Connection
- INTRODUCTION
- DEFINITION
- DARLING'S MODIFICATION OF TYPES OF TAPVC
- PATHOPHYSIOLOGY OF TAPVC
- TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION (SUPRACARDIAC)
- X-RAY CHEST PAV IN TAPVC (FIGS 2A AND B)
  - Shape and Size Character
- X-RAY CHEST TAPVC (FIGS 2A AND B)
- ECG IN TAPVC (FIG. 3)
- ANESTHETIC CONSIDERATION
- PREOPERATIVE CONSIDERATION
- INTRAOPERATIVE CONSIDERATION
- PREOPERATIVE ASSESSMENT OF 2D TEE FOR TAPVC (FIGS 4 TO 6)
  - On 2D TEE
- POSTOPERATIVE TEE ASSESSMENT
- 3D TEE
- 3D TEE FOR SURGICAL TECHNIQUE
- CONCLUSION
CHAPTER 19:TEE for Cor Triatriatum
- DEFINITION
- PATHOPHYSIOLOGY
- EMBRYOLOGICAL ORIGIN
- INTRAOPERATIVE TEE (FIGS 2 AND 3)
  - Intraoperative TEE Assessment (Figs 4 and 5)
- CONGENITAL CARDIAC LESIONS ASSOCIATED WITH CTS4
- DIFFERENTIATION BETWEEN SUPRAMITRAL RING AND COR TRIATRIATUM (FIGS 6A AND B)
CHAPTER 20:TEE for Left Superior Vena Cava
- DEFINITION
- PATHOPHYSIOLOGY
- IMPORTANCE OF LSVC TO THE CARDIAC SURGEON
- IDENTIFICATION
- TEE FOR LSVC DIAGNOSIS (FIGS 1 TO 6)
- LSVC PRESENCE IN CHD
CHAPTER 21:TEE for Pulmonary Artery Hypertension
- INTRODUCTION
- CAUSES OF PULMONARY ARTERY HYPERTENSION
- CHEST X-RAY FEATURES OF PAH (FIGS 1A AND B)
  - Precapillary PAH
  - Dominant Right Ventricle with Pulmonary Hypertension
- ECHOCARDIOGRAPHIC FEATURES IN PULMONARY ARTERIAL HYPERTENSION
- PREOPERATIVE 2D TEE ASSESSMENT
- EVALUATION WITH COLOR FLOW DOPPLER (TABLE 1)
  - Estimation of PVR
- CONCLUSION
CHAPTER 22:TEE for Eisenmenger's Syndrome
- INTRODUCTION
- PATHOPHYSIOLOGY OF EISENMENGER'S SYNDROME
  - Examination in Eisenmenger's Syndrome
- CLINICAL IMPLICATIONS
- EISENMENGER'S SYNDROME: A PROGRESSIVE DISEASE
- EISENMENGER'S PHYSIOLOGY: CLINICAL ASSESSMENT (FIGS 2A TO C)
- CHOICES
- 2D ECHO: EISENMENGER'S SYNDROME (FIGS 6A TO D)
  - Course in Adulthood
- DIFFERENT CONGENITAL INTRACARDIAC OR EXTRACARDIAC DEFECTS CAN CAUSE EISENMENGER'S SYNDROME
- ECHO PREDICTORS
- CONCLUSION
- POINTS TO BE REMEMBER
CHAPTER 23:TEE for Patent Foramen Ovale
- INTRODUCTION
- STRUCTURE OF PATENT FORAMEN OVALE
- CLINICAL FEATURES OF PATENT FORAMEN OVALE
- DETECTION OF A RIGHT-TO-LEFT SHUNT THROUGH A PFO
- TRANSESOPHAGEAL ECHOCARDIOGRAM
- PREOPERATIVE TEE ASSESSMENT OF PATENT FORAMEN OVALE
- POSTOPERATIVE ECHO ASSESSMENT FOLLOWING REPAIR
CHAPTER 24:TEE for Tricuspid Atresia
- INTRODUCTION
- DEFINITION
- ANATOMY
- ETIOLOGY AND CLINICAL FEATURES
- CHEST X-RAY OF TRICUSPID ATRESIA
- ECG FINDINGS
- CASE PRESENTATION (FIGS 2 TO 7)
- TEE CONFIRMS THE DIAGNOSIS OF TRICUSPID ATRESIA
CHAPTER 25:Echo Resources
- ECHO RESOURCES
- SOCIETIES
- WEBSITES

INDEX

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Index

Chapter Notes