Intraoperative Echocardiography In The Part Of Complex Congenital Heart Disease

Assessment of Lecompte Procedure (REV) by Intraoperative Transesophageal EchocardiographyObjective : To assess the REV procedure by using intraoperative transesophageal echocardiography.Methods: Ten patients with complicated congenital heart diseases who were arranged for REV procedure were included in this study. Among them, 5 with transposition of the great arteries, 2 with corrected transposition of the great arteries, 6 with double outlet of the right ventricle,and all of them with the intracardiac shunt. IOTEE was preformed before cardiopulmonary bypass in the operating room. The function of the valves, the atrialventricular and ventriculoarterial connection and the intracardiac shunt were assessed by the IOTEE imaging, which helped the surgeons to determine the feasibility and probability of the REV procedure. The alterations of the morphology and hemodynamic informations were evaluated by IOTEE when the patients were off pump.Results: All the intracardiac shunts were dissapeared, no residual shunt were detected .All the patients realize the normal connections of the artrium-ventricle and ventricle-arteries.One with identification of flow acceleration of the left ventricular outflow tract, of which the peak gradient is 25mmHg;The other two with identification of flow acceleration of the right ventricular outflow tract , the peak gradient is 16mmHg. Two had right ventricular dysfunction,which need the second cardiopulmonary bypass and extracorporeal membrane oxygenator (ECMO) treatment.Conclusions: IOTEE provides a practial and valuable technique during REV procedure which can both evaluate and guide the operations of the complicated congenital heart diseases. Guiding and Monitering modified Nikaidoh Procedure by Intraoperative transesophageal EchocardiographyObjective: To guide and moniter the modified Nikaidoh procedure by using intraoperative transesophageal echocardiography.Methods: Seventeen patients with complicated congenital heart diseases who were arranged for modified Nikaidoh procedure were included in this study. Among them, 10 with transposition of the great arteries, 4with corrected transposition of the great arteries, 3 with double outlet of the right ventricle,and all of them with stenosis of the left ventricular outflow tracts .IOTEE was preformed before cardiopulmonary bypass in the operating room. The function of the valves, the atrialventricular and ventriculoarterial connection ,the biventricular outflow tracts and the intracardiac shunt were assessed by the IOTEE imaging, which helped the surgeons to determine the feasibility and probability of the modified Nikaidoh procedure. The alterations of the morphology and hemodynamic informations were evaluated by IOTEE when the patients were off pump.Results: All the intracardiac shunts were dissapeared, no residual shunt were detected .All the patients realized the normal connections of the artrium-ventricle and ventricle-arteries. One with identification of flow acceleration of the left ventricular outflow tract ,of which the peak gradient was 25mmHg;The other two with identification of flow acceleration of the right ventricular outflow tract , the peak gradient were both over 10mmHg. One had right ventricular dysfunction,which need the extracorporeal membrane oxygenator (ECMO) treatment.Conclusions: IOTEE provides a practial and valuable technique during modified Nikaidoh procedure ,which can both evaluate and guide the operations of the complicated congenital heart diseases.