Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-05T10:37:37.415Z Has data issue: false hasContentIssue false
  • English
  • Français

The role of transesophageal echocardiography in the diagnosis and management of children and young adults with valvar diseases of the left heart

Published online by Cambridge University Press:  19 August 2008

Maurice P. Leung ,
Tak-Cheung Yung ,
Bobby Chan ,
Clement Chiu ,
Jan Lee  and
Che-Kueng Mok
Maurice P. Leung*
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Tak-Cheung Yung
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Bobby Chan
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Clement Chiu
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Jan Lee
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
Che-Kueng Mok
Affiliation:
From the Department of Paediatrics and Surgery, The Grantham Hospital, University of Hong Kong, Hong Kong
*
Dr. Maurice P. Leung, Paediatric Cardiological Division, University of Hong Kong, Grantham Hospital, 125 Wong Chuk Hang Road, Aberdeen, Hong Kong. Tel. (852) 554-6471 Ext. 249; Fax. (852) 554-2011.
Get access Rights & Permissions [Opens in a new window]

Summary

The role of transesophageal echocardiography in the diagnosis and management of left-sided cardiac valvar disease in children and young adults was assessed in terms of whether additional information (over transthoracic echocardiography) could be obtained, and whether the added information contributed to the better management of the patients. Between January 1991 to August 1992, 27 consecutive patients were studied. Their age ranged from 2.5 to20 years (mean 12.7), with body weights ranging between 12 and 60 kg (mean 35.6). Twelve of the children suffered from atrioventricular valvar disease, 13 had predominant aortic valvar lesions and two had mixed valvar pathologies. Additional information was obtained by transesophageal over that of transthoracic echocardiography in 18 children (67%). Transesophageal echocardiography clarified the etiologies or mechanism of valvar regurgitation in eight and seven children with atrioventricular and aortic pathologies, respectively. The technique correctly diagnosed severe mitral regurgitation underestimated by conventional technique, detected a missed eccentric aortic regurgitant jet and convincingly excluded bacterial vegetations in one case each. The investigation contributed to the better management of three children (11%) by providing information that allowed the appropriate choice of therapy. Transesophageal echocardiography, therefore, is a useful technique for the diagnosis and management of valvar disease of the left heart in children and young adults.

Keywords

Transesophageal echocardiographymitral valveaortic valve
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 4 , October 1994 , pp. 373 - 380
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Honey, M, Gough, SH, Katsaros, S, Miller, GAH, Thruaisingham, V. Left ventricular cine-angiography in the assessment of mitral regurgitation. Br Heart J 1969; 31: 596–602.CrossRefGoogle Scholar
2.Baron, MG. Angiocardiographic evaluation of valvar insufficiency. Circulation 1971; 43: 599–605.CrossRefGoogle Scholar
3.Ciobanu, M, Abbasi, AS, Allen, M, Hermer, A, Spellberg, R. Pulsed-Doppler echocardiography in the diagnosis and estimation of severity of aortic insufficiency. Am J Cardiol 1982; 49: 339–343.CrossRefGoogle ScholarPubMed
4.Miyatake, K, Nimura, Y, Sakakibara, H. Localization and direction of mitral regurgitant flow in mitral orifices studied with combined use of ultrasonic pulsed Doppler technique and two dimensional echocardiography. Br Heart J 1982; 48: 449–458.CrossRefGoogle ScholarPubMed
5.Hozumi, T, Yoshikawa, J, Yoshida, K, Yamaura, Y, Akasaka, T, Shakudo, M. Direct visualization of ruptured chordae tendineae by transesophageal two-dimensional echocardiography. J Am Coll Cardiol 1990; 16: 1315–1319.CrossRefGoogle ScholarPubMed
6.Zamorano, J, Erbel, R, Mackowski, T, Alfonso, F, Meyer, J. Usefulness of transesophageal echocardiography for diagnosis of mitral valve prolapse. Am J Cardiol 1992; 69: 419–422.CrossRefGoogle ScholarPubMed
7.Bailal, RS, Mahan, EF III, Nanda, NC, Sanyal, R. Aortic and mitral valve perforation: diagnosis by transesophageal echocardiography and Doppler color flow imaging. Am Heart J 1991; 121: 214–217.CrossRefGoogle Scholar
8.Castello, R, Fagan, L, Lenzen, P, Pearson, AC, Labovitz, AJ. Comparison of transthoracic and transesophageal echocardiography for assessment of left-sided valvular regurgitation. Am J Cardiol 1991; 68: 1677–1680.CrossRefGoogle ScholarPubMed
9.Ritter, SB. Transesophageal real-time echocardiography in infants and children with congenital heart disease. J Am Coll Cardiol 1991; 18: 569–580.CrossRefGoogle ScholarPubMed
10.Sreeram, N, Stümper, OFW, Kaulitz, R, Hess, J, Roelandt, JRTC, Sutherland, GR. Comparative value of transthoracic and transesophageal echocardiography in assessment of congenital abnormalities of the atrioventricular junction. J Am Coll Cardiol 1990; 16: 1205–1214.CrossRefGoogle ScholarPubMed
11.Roberson, DA, Muhiudeen, IA, Silverman, NH, Turley, K, Haas, GS, Cahalan, MK. Intraoperative transesophageal echocardiography of atrioventricular septal defect. J Am Coll Cardiol 1991; 18: 537–545.CrossRefGoogle ScholarPubMed
12.Seward, JB, Khandheria, BK, Edwards, WD, Oh, JK, Freeman, WK, Tajik, AJ. Biplanar transesophageal echocardiography: Anatomic correlations, image orientation, and clinical applications. Mayo Clin Proc 1990; 65: 1193–1213.CrossRefGoogle ScholarPubMed
13.Carpentier, A. Cardiac valve surgery: the “French correction”. J Thorac Cardiovasc Surg 1980; 86: 323–337.CrossRefGoogle Scholar
14.Nunley, DL, Starr, A. The evolution of reparative techniques for the mitral valve. Ann Thorac Surg 1983; 37: 393–397.CrossRefGoogle Scholar
15.Carpentier, A, Chauvaud, S, Fabiani, JN. Reconstructive surgery of mitral valve incompetence: ten year appraisal. J Thorac Cardiovasc Surg 1980; 79: 338–348.CrossRefGoogle ScholarPubMed
16.Herrmann, HC, Wilkins, GT, Abascal, VM, Weyman, AE, Block, PC, Palacios, IF. Percutaneous balloon valvotomy for patients with mitral stenosis: analysis of factors influencing results. J Thorac Cardiovasc Surg 1988; 96: 33–38.CrossRefGoogle Scholar
17.Palacios, IF, Block, PC, Wilkins, GT, Weyman, AE. Follow-up of patients undergoing mitral balloon valvotomy. Circulation 1989; 79: 573–579.CrossRefGoogle ScholarPubMed
18.Helmeke, F, Nanda, NC, Siung, MC, Sota, B, Adey, CK, Goyal, RG, Gatewood, RP. Color Doppler assessment of mitral regurgitation with orthogonal planes. Circulation 1987; 75: 175–183.CrossRefGoogle Scholar
19.Perry, GI, Hencke, F, Nanda, NC, Byard, C, Soto, B. Evaluation of aortic insufficiency by Doppler color flow mapping. J Am Coll Cardiol 1987; 9: 952–959.CrossRefGoogle ScholarPubMed
20.Griffin, ML, Sullivan, ID, Anderson, RH, Macartney, FJ. Doubly committed subarterial ventricular septal defect: new morphological criteria with echocardiographic and angiocar diographic correlation. Br Heart J 1988; 59: 474–479.CrossRefGoogle Scholar
21.Schmidt, KG, Cassidy, SC, Silverman, NH, Stanger, P. Doubly committed subarterial ventricular septal defects: echocardiographic features and surgical implications. J Am Coll Cardiol 1988; 12: 1538–1546.CrossRefGoogle ScholarPubMed
22.Nellessen, U, Schnittger, I, Appleton, CP. Transesophageal two-dimensional echocardiography and color Doppler flow velocity mapping in the evaluation of cardiac valve prostheses. Circulation 1988; 78: 848–855.CrossRefGoogle ScholarPubMed