Transesophageal Echocardiography for Pediatric and Congenital Heart Disease

Preface
Acknowledgments
Introduction
Contents
Contributors
1: Science of Ultrasound and Echocardiography
Introduction
Background
Physics of Sound and Ultrasound
Sound: Definition and Properties
Reflection: The Key to Ultrasonic Imaging
Attenuation and Ultrasonic Imaging
Important Principles of Echocardiographic Image Formation
Transducers
Transducer Beam Formation and Geometry
Arrays
TEE Transducers
Pulse Repetition Frequency
Generation of an Echocardiographic Image
Image Resolution
Spatial Resolution
Axial Resolution
Lateral Resolution
Elevational Resolution
Optimizing Spatial Resolution
Contrast Resolution
Temporal Resolution
Tissue Harmonic Imaging
Doppler Echocardiography
The Doppler Principle
Spectral Doppler
Continuous Wave Doppler
Pulsed Wave Doppler
Aliasing and the Nyquist Limit
Combining the Spectral Doppler Modalities
Avoidance of Artifacts with Spectral Doppler
Spectral Doppler for Hemodynamic and Myocardial Assessment
Pressure Gradients and Intracardiac Pressures
Cardiac Flow
Myocardial Function
Color Flow Doppler
Importance of Color Flow Doppler
Audible Doppler
Overview of the Echocardiography Machine
Artifacts
Mirror Image Artifacts
Reverberation Artifacts
Side Lobes and Grating Lobes
Acoustic Shadowing
Digital Image Storage and DICOM
Summary
Questions and Answers
References
2: Instrumentation
Introduction
Evolution of TEE
History of TEE Probes for Children
Single-Plane Probes
Biplane Probes
Multiplane Probes
Mini-multiplane Pediatric TEE Probe
Micro-multiplane Pediatric TEE Probe
Current Probes for TEE
3D TEE Probe
Principles of the TEE Transducer
Current TEE Transducer Technology
Sector Size
Frame rate
Zoom
Image Optimization
Color flow Imaging Optimization
M-Mode
Quantitative Assessment
3D TEE Imaging
Clinical Applications: TEE for Children with CHD
Care and Maintenance of TEE Probes
TEE Probe Handling During the Study
Cleaning, Disinfection, and Storage
TEE Probe Maintenance
Other Techniques Applicable to TEE: Interactive and Intraprocedural Imaging
Epicardial Echocardiography
Intracardiac Echocardiography
Recent Advances in Echocardiography
Artificial intelligence
High Frame Rate Cardiac Imaging
New Beamforming Techniques
The Future
Questions and Answers
References
3: Indications and Guidelines in Pediatric and Congenital Heart Disease
Introduction
Indications for Transesophageal Echocardiography
Adult-Based Indications Related to Congenital Heart Disease
Pediatric and Congenital-Based Indications
Diagnostic Indications
Perioperative Indications
During Cardiovascular Surgery
During Noncardiac Surgery
TEE-Guided Interventions
Applications of Three-Dimensional Transesophageal Echocardiography
Applications of Transesophageal Echocardiography in the Ambulatory Setting
Role of the Sonographer in Transesophageal Echocardiography
Guidelines for Training and Maintenance of Competence in Transesophageal Echocardiography
Knowledge Base and Skills
Training Guidelines
For Physicians Who Practice Pediatric Cardiology and Adult Congenital Heart Disease
For Physicians Not Formally Trained in Pediatric Cardiology or Adult Congenital Heart Disease
Certification in Transesophageal Echocardiography
Safety Considerations and Complications
Data Regarding Safety
Probe Insertion Failure
Trauma to the Gastrointestinal Tract
Airway and Hemodynamic Concerns
Risk of Bacteremia and Endocarditis Prophylaxis
Contraindications
Summary
Questions and Answers
References
4: Structural Evaluation of the Cardiovascular System
Introduction
Approach to Structural Evaluation
General Principles for Cardiovascular Assessment
Probe Orientation and Manipulation
Cross-Sectional TEE Views Used for CHD Evaluation
TEE Probe Locations and Views Used in This Textbook
Image Display Conventions Used in This Textbook
Method of Structural Evaluation of CHD by TEE
Initiation of TEE Study, Establishment of Atrial Situs and Systemic/Pulmonary Venous Return
Atria and Atrial Septum
Atrioventricular Valve Evaluation
Ventricles and Ventricular Septum
Outflow Tracts and Semilunar Valves
Coronary Artery Evaluation
Main and Branch Pulmonary Arteries, Aortic Arch
Descending Aorta
Evaluation of Cardiac Malposition
Tabular Synopsis of the Segmental Approach by TEE
Summary
Questions and Answers
References
5: Functional Evaluation of the Heart
Introduction
Transesophageal Echocardiographic Evaluation of Ventricular Function in Congenital Heart Disease
Indications
Imaging Planes
Echocardiographic Assessment of Global Systolic Ventricular Function
Left Ventricular Shortening Fraction and Fractional Area Change
Left Ventricular Ejection Fraction
Velocity of Circumferential Fiber Shortening and the Stress–Velocity Index
Doppler Parameters of Global Left Ventricular Systolic Function
Left Ventricular dP/dt
Myocardial Performance Index (Tei Index)
Echocardiographic Assessment of Regional Systolic Ventricular Function
Two-Dimensional Imaging
Tissue Doppler Imaging and Strain Imaging
Assessment of Diastolic Ventricular Function by Transesophageal Echocardiography
Mitral Inflow Doppler
Pulmonary Venous Doppler
Tissue Doppler Imaging
Tissue Doppler Studies in Normal Children
Color M-Mode Flow Propagation Velocity
Atrial Assessment of Diastolic Function
Echocardiographic Assessment of Right Ventricular Function
Right Ventricular Myocardial Performance Index
Right Ventricular dP/dt
Right Ventricular Tissue Doppler Imaging
Acoustic Quantification and Right Ventricular Function
Three-Dimensional Echocardiography and Right Ventricular Function
Echocardiographic Assessment of Single Ventricular Function in Patients with Complex Congenital Heart Disease
Summary
Case-Based Examples
Case #1
TEE Findings:
Case #2
TEE Findings:
Case #3
TEE Findings:
Questions and Answers
References
6: Systemic and Pulmonary Venous Anomalies
Introduction
Systemic Veins
General Considerations
Normal Systemic Venous Anatomy
Transesophageal Examination of Normal Systemic Veins
Two-Dimensional Imaging
Systemic Venous Flow Doppler: Normal and Abnormal Patterns
Systemic Venous Anomalies
Persistent Left Superior Vena Cava Draining into the Coronary Sinus
General Considerations
Transesophageal Echocardiography
Anomalous Subaortic Position of the Innominate Vein (Retroaortic Innominate Vein)
General Considerations
Transesophageal Echocardiography
Persistent Left Superior Vena Cava Draining into the Left Atrium
General Considerations
Transesophageal Echocardiography
Persistent Left Superior Vena Cava Draining into a Coronary Sinus with a Coronary Sinus–Left Atrial Fenestration
General Considerations
Transesophageal Echocardiography
Right Superior Vena Cava Connection to the Left Atrium
General Considerations
Transesophageal Echocardiography
Interrupted Inferior Vena Cava with Azygos Continuation
General Considerations
Transesophageal Echocardiography
Left-Sided Inferior Vena Cava
General Considerations
Transesophageal Echocardiography
Pulmonary Veins
General Considerations
Normal Pulmonary Venous Anatomy
Transesophageal Imaging of Normal Pulmonary Veins
Two-Dimensional Imaging
Pulmonary Venous Flow Doppler: Normal and Abnormal Patterns
Pulmonary Venous Anomalies
Partial Anomalous Pulmonary Venous Connection
General Considerations
Transesophageal Echocardiography
Postoperative Considerations in PAPVC
Scimitar Syndrome
General Considerations
Transesophageal Echocardiography
Partial Anomalous Pulmonary Venous Drainage Due to Malposition of Septum Primum
General Considerations
Transesophageal Echocardiography
Total Anomalous Pulmonary Venous Connection
General Considerations
Transesophageal Echocardiography
Supracardiac TAPVC
General Considerations
Transesophageal Echocardiography
Infracardiac TAPVC
General Considerations
Transesophageal Echocardiography
Cardiac-Type of TAPVC
General Considerations
Transesophageal Echocardiography
Mixed TAPVC
General Considerationss
Transesophageal Echocardiography
Postoperative Considerations in TAPVC
Summary
Case-Based Examples
Case #1
TEE Findings:
Suggested Reading/References
Case #2
TEE Findings:
Suggested Reading/References
Questions and Answers
References
7: Atrial Septal Defects and Atrial Anomalies
Introduction
Atrial Septal Defects
General Considerations
Secundum Atrial Septal Defect
Primum Atrial Septal Defect
Sinus Venosus Atrial Septal Defect
Coronary Sinus Atrial Septal Defect
Patent Foramen Ovale
Transesophageal Echocardiographic Examination
Goals of the Transesophageal Echocardiographic Examination
Pre-procedure Assessment: Surgical and Transcatheter Considerations
Post-procedure Assessment: Surgical and Transcatheter Considerations
Juxtaposition of the Atrial Appendages
General Considerations
Transesophageal Echocardiographic Examination
Goals of the Transesophageal Echocardiographic Examination
Surgical and Transcatheter Considerations
Cor Triatriatum
General Considerations
Transesophageal Echocardiographic Examination
Goals of the Transesophageal Echocardiographic Examination
Surgical and Transcatheter Considerations
Preoperative Assessment
Postoperative Assessment
Summary
Case-Based Examples
Case #1
TEE Findings:
Suggested Reading/References
Case #2
TEE Findings:
Suggested Reading/References
Case #3
TEE Findings:
Suggested Reading/References
Case #4
TEE Findings:
Suggested Reading/References
Case #5
TEE Findings:
Suggested Reading/References
Questions and Answers
References
8: Atrioventricular Septal Defects
Introduction
General Considerations
Nomenclature and Classification
Complete and Incomplete (Partial) Defects
Intermediate and Transitional Forms
Congenital Heart Surgery Nomenclature and Database Project Classification
Rastelli Classification
Balanced Versus Unbalanced Defect Classification
Morphological Features
Atrioventricular Septal Defects
Common Atrioventricular Valve
Papillary Muscles
Aortic Valve Position Relative to the Atrioventricular Valve(s)
Left Ventricular Outflow Tract
Pathophysiology
Shunting Patterns
Hemodynamic Consequences
Management
Transesophageal Echocardiographic Assessment
Preoperative TEE Evaluation
Two-Dimensional Imaging of Complete Defects
The Atrioventricular Septum and the Common Atrioventricular Valve
Papillary Muscles
The Interatrial Communication
The Ventricular Communication
The Left Ventricular Outflow Tract
Commitment of the Atrioventricular Junction to the Ventricles
Two-Dimensional Imaging of Partial Defects
Doppler Evaluation of Defects
Associated Cardiac Defects
Postoperative TEE Evaluation
Residual Left Atrioventricular Valve Problems
Left Atrioventricular Valve Regurgitation
Left Atrioventricular Valve Stenosis
Intracardiac Shunts
Left Ventricular Outflow Tract Obstruction
Three-Dimensional Echocardiographic Imaging
Summary
Case-Based Examples
Case #1
TEE Findings:
Preoperative Examination
Postoperative Examination
Suggested Reading/References
Case #2
TEE Findings:
Preoperative Examination
Postoperative Examination
Suggested Reading/References
Case #3
TEE Findings:
Preoperative Examination
Postoperative Examination
Postoperative Examination (After Revision of the Repair)
Suggested Reading/References
Questions and Answers
References
9: Mitral and Tricuspid Valve Anomalies
Introduction
Congenital Mitral Valve Anomalies
General Considerations Regarding Transesophageal Imaging of the Mitral Valve
Congenital Anomalies Associated with Mitral Stenosis and/or Regurgitation
Typical Congenital Mitral Valve Dysplasia
Morphology
Management Considerations
Transesophageal Echocardiography
Parachute Mitral Valve
Morphology
Management Considerations
Transesophageal Echocardiography
Supravalvar Mitral Membrane
Management Considerations
Transesophageal Echocardiography
Double Orifice Mitral Valve
Morphology
Management Considerations
Transesophageal Echocardiography
Mitral Arcade
Morphology
Management Considerations
Transesophageal Echocardiography
Congenital Mitral Valve Regurgitation
Morphology
Management Considerations
Transesophageal Echocardiography
Isolated Cleft of the Mitral Valve
Morphology
Management Considerations
Transesophageal Echocardiography
Straddling Mitral Valve
Morphology
Management Considerations
Transesophageal Echocardiography
Mitral Valve Prolapse
Morphology
Management Considerations
Transesophageal Echocardiography
Infective Endocarditis
Congenital Tricuspid Valve Anomalies
Ebstein Anomaly
Morphology
Management Considerations
Transesophageal Echocardiography
Dysplastic Tricuspid Valve
Morphology
Management Considerations
Transesophageal Echocardiography
Assessment of Tricuspid Regurgitation
Postoperative TEE Evaluation
Summary
Case-Based Studies
Case #1
TEE Findings:
Suggested Reading/References
Case #2
TEE Findings:
Preoperative Study
Postoperative Study After Initial Surgery
Postoperative Study At Subsequent Surgery
Suggested Reading/References
Case #3
TEE Findings:
Preoperative Study
Postoperative Study
Suggested Reading/References
Case #4
TEE Findings:
Preoperative Study
Postoperative Study
Suggested Reading/References
Case #5
TEE Findings:
Preoperative Study
Postoperative Study
Suggested Reading/References
Case #6
TEE Findings:
Preoperative Study
Postoperative Study
Suggested Reading/References
Questions and Answers
References
10: Ventricular Septal Defects
Introduction
Morphologic Classification of Ventricular Septal Defects
Evaluation of Ventricular Septal Defects by TEE
Goals of the TEE Evaluation for VSDs
Preoperative or Preinterventional Assessment
Postoperative or Postinterventional Assessment
Method of TEE Evaluation of VSDs
Intraoperative Evaluation of VSDs
Preoperative Assessment
Postoperative Assessment
TEE in the Cardiac Catheterization Lab
Three-Dimensional TEE
Summary
Case-Based Examples
Case #1
TEE Findings:
Preoperative Study (Fig. 10.17a, b; Video 10.17)
Postoperative Study #1 (Fig. 10.18; Video 10.18)
Postoperative Study #2 (Fig. 10.19; Video 10.19)
Case #2
TEE Findings:
Preoperative Study (Fig. 10.20a, b; Video 10.20)
Postoperative Study #1 (Fig. 10.21; Video 10.21)
Postoperative Study #2 (Fig. 10.22; Video 10.22)
Case #3
TEE Findings:
Preoperative Study (Fig. 10.23; Video 10.23)
Postoperative Study #1 (Fig. 10.24; Video 10.24)
Postoperative Study #2 (Fig. 10.25; Video 10.25)
Case #4
TEE Findings:
Postoperative Study #1 (Fig. 10.26; Video 10.26)
Postoperative Study #2 (Fig. 10.27; Video 10.27)
Questions and Answers
References
11: Single Ventricle
Introduction
Single Ventricle: Anatomic Types
General Considerations for TEE Evaluation
Hypoplastic Left Heart Syndrome
Hypoplastic Right Heart Syndrome
Tricuspid Atresia
Univentricular Atrioventricular (AV) Connection
Heterotaxy
Other Types of Single Ventricle
Surgery for the Single Ventricle
Preoperative Assessment
Surgical Interventions for Single Ventricle and their Assessment by TEE
Modified Blalock-Taussig and Central Shunts
Pulmonary Artery Band
Damus-Kaye-Stansel Procedure
Norwood Procedure
Bidirectional Cavopulmonary (Glenn) Anastomosis
Fontan Procedure
Additional Evaluation and Long-Term Considerations
Summary
Case-Based Examples
Case #1
TEE findings:
Case #2
TEE findings:
Suggested Reading/References
Case #3
TEE findings:
Suggested Reading/References
Questions and Answers
References
12: Cardiac Malposition and Heterotaxy
Introduction
Demographics of Cardiac Malpositions and Heterotaxy
Heterotaxy
Transesophageal Echocardiography Imaging
Cardiac Position, Viscero-Atrial Situs, Atrial Anatomy
Systemic and Pulmonary Venous Return
Atrioventricular Valve(s) and Ventricular Assessment
Ventriculo-Arterial Junction and Outflow Tracts
Great Artery Evaluation
Coronary Artery Evaluation
Postoperative TEE Evaluation
Summary
Case-Based Examples
Case #1
TEE findings:
Case #2
TEE findings:
Case #3
TEE findings:
Questions and Answers
References
13: Outflow Tract Anomalies
Introduction
Utility of Transesophageal Echocardiography
Normal Anatomy
Left Ventricular Outflow Tract Anomalies
Valvar Aortic Stenosis
Subvalvar Aortic Stenosis
Supravalvar Aortic Stenosis
Aortic Regurgitation
Aneurysm of the Proximal Aorta
Right Ventricular Outflow Tract Anomalies
Valvar Pulmonary Stenosis
Subvalvar Pulmonary Stenosis (Double Chamber Right Ventricle)
Pulmonary Regurgitation
Summary
Case-Based Examples
Case #1
TEE Findings:
Suggested Reading/References
Case #2
TEE Findings:
Suggested Reading/References
Questions and Answers
References
14: Conotruncal Anomalies
Introduction
General Considerations
Specific Lesions
Tetralogy of Fallot
Anatomy
Transesophageal Echocardiographic Evaluation
Surgical Considerations
Double Outlet Right Ventricle
Anatomy
Transesophageal Echocardiographic Evaluation
Surgical Considerations
Truncus Arteriosus
Anatomy
Transesophageal Echocardiographic Evaluation
Surgical Considerations
Conclusion
Case-Based Examples
Case #1
TEE Findings:
Suggested Reading/References
Case #2
TEE Findings:
Suggested Reading/References
Case #3
TEE Findings:
Suggested Reading/References
Questions and Answers
References
15: Transposition Complexes
Introduction
Specific Lesions
Transposition of the Great Arteries
General Considerations
Etiology and Epidemiology
Embryology
Morphology
Pathophysiology
Surgical Considerations
Imaging Considerations
Preoperative TEE
Postoperative TEE Assessment after the Arterial Switch Operation
Postoperative TEE Assessment after Senning or Mustard Procedure
Postoperative TEE Assessment after Complex Repairs (Rastelli and Nikaidoh Procedure)
Role of TEE in Late Reintervention/Reoperation after Arterial Switch Operation
Role of TEE in Late Reintervention/Reoperation after Atrial Switch Operation
Congenitally Corrected Transposition of the Great Arteries
General Considerations
Etiology and Epidemiology
Embryology
Morphology
Pathophysiology
Surgical Considerations
Imaging Considerations
Preoperative TEE
Role of TEE in Physiologic Repair
Role of TEE in Anatomic Repair
Role of TEE During PA Banding
Role of TEE During Double-Switch Operation
Summary
Case-Based Examples
Case #1
TEE Findings:
Suggested Reading/References
Case #2
TEE Findings:
Suggested Reading/References
Acknowledgement
Case #3
TEE Findings:
Suggested Reading/References
Questions and Answers
References
16: Great Artery and Vascular Anomalies
Introduction
Abnormal Vascular Connections
Patent Ductus Arteriosus
Anatomic Features
Associated Defects
Pathophysiology
Management Considerations
Applications of Transesophageal Echocardiography
Goals of TEE Prior to Catheter or Surgical Intervention
Goals of TEE After Catheter or Surgical Intervention
Aortopulmonary Window
Anatomic Features
Associated Defects
Pathophysiology
Management Considerations
Applications of Transesophageal Echocardiography
Goals of TEE Prior to Surgical Intervention
Goals of TEE After Surgical Intervention
Anomalies of the Branch Pulmonary Arteries
Anomalous Origin of the Left Pulmonary Artery from the Right Pulmonary Artery
Anatomic Features
Associated Defects
Pathophysiology
Management Considerations
Applications of Transesophageal Echocardiography
Goals of TEE Prior to Surgical Intervention
Goals of TEE After Surgical Intervention
Anomalous Origin of a Branch Pulmonary Artery from the Aorta
Anatomic Features
Associated Defects
Pathophysiology
Management Considerations
Applications of Transesophageal Echocardiography
Goals of TEE Prior to Surgical Intervention
Goals of TEE After Surgical Intervention
Anomalies of the Aortic Arch
Coarctation of the Aorta
Anatomic Features
Associated Defects
Pathophysiology
Management Considerations
Applications of Transesophageal Echocardiography
Goals of TEE Prior to Surgical Intervention
Goals of TEE After Surgical Intervention
Interrupted Aortic Arch
Anatomic Features
Associated Defects
Pathophysiology
Management Considerations
Applications of Transesophageal Echocardiography
Goals of TEE Prior to Surgical Intervention
Goals of TEE After Surgical Intervention
Summary
Case-Based Examples
Case #1
TEE Findings:
Preoperative Study
Postoperative Study
Suggested Reading/References
Case #2
TEE Findings:
Preoperative Study
Postoperative Study
Suggested Reading/References
Case #3
TEE Findings:
Preoperative Study
Postoperative Study
Suggested Reading/References
Questions and Answers
References
17: Congenital Coronary Artery Anomalies
Introduction
Role and Utility of Transesophageal Echocardiography in the Evaluation of Congenital Coronary Artery Anomalies
Anomalous Aortic Origin of a Coronary Artery
Anatomy
Transesophageal Echocardiographic Evaluation
Anomalous Origin of Left Coronary Artery from Main Pulmonary Artery
Anatomy
Transesophageal Echocardiographic Evaluation
Coronary Artery Fistula
Anatomy
Transesophageal Echocardiographic Evaluation
Kawasaki Disease
Anatomy
Transesophageal Echocardiographic Evaluation
Summary
Case-Based Example
Case #1
TEE Findings:
Suggested Reading/References
Questions and Answers
References
18: Intraoperative and Postoperative Applications
Introduction
Evolution of Intraoperative Echocardiography in CHD
Epicardial Echocardiography
Transesophageal Echocardiography
Early Developments
Monoplane TEE
Biplane TEE
Multiplane TEE
Intracardiac Catheters
Three-Dimensional TEE
TEE Probe Selection
Role of Intraoperative Echocardiography
Impact on Surgical Management
Impact on Medical Management
Guiding Catheter Placement
Identifying Intracardiac Air and Confirming Cardiac Deairing
Assessing Ventricular Loading Conditions
Assessing Systolic Left Ventricular Function
Assessing Systolic Right Ventricular Function
Assessing Diastolic Ventricular Function
Detecting Myocardial Ischemia
Impact on Anesthetic and Hemodynamic Management
Cost-Effectiveness of Intraoperative TEE
Limitations and Pitfalls of Intraoperative TEE
Return to Cardiopulmonary Bypass Decisions
Correlation of Intraoperative and Postoperative Echocardiographic Findings
TEE for Evaluation in the Postoperative Setting
Summary
Questions and Answers
References
19: Other Applications, Including the Critical Care Setting
Introduction
Infective Endocarditis
Echocardiographic Manifestations of IE
Goals of TEE Imaging in IE
Cardiac Thrombi
Prosthetic Valves
Echocardiographic Evaluation of Prosthetic Valves
Doppler Evaluation of Prosthetic Valves
Summary
Case-Based Examples
Case #1
TEE Findings:
Case #2
TEE Findings:
Questions and Answers
References
20: Applications for Non-Congenital Heart Disease in Pediatric Patients
Introduction
Solid Organ Transplantation
Heart Transplantation
Evaluation of Cardiac Transplant Recipients
Screening of Cardiac Transplant Donors
Intraoperative TEE Evaluation
Intraoperative Monitoring and Assessment
Intraoperative Post-Transplant Evaluation
Lung Transplantation
Intraoperative TEE Evaluation
Heart and Lung Transplantation
Intraoperative TEE Evaluation
Liver Transplantation
Safety of TEE in Liver Transplantation
Preoperative Liver Transplant Evaluation
Intraoperative Management During Liver Transplantation
Mechanical Circulatory Support in Children
Extracorporeal Membrane Oxygenation
General Considerations
Most Common Types of ECMO
Veno-arterial (VA) ECMO
Veno-venous (VV) ECMO
Veno-venous-arterial (VVA) ECMO
TEE Evaluation
Cannula Position
Veno-arterial ECMO
Veno-venous ECMO
Mechanical Support Complications
Pericardial Effusion
Cannula Malposition/Thrombi
Inadequate Decompression
Weaning
Ventricular Assist Devices
General Considerations
Types of Devices
Pulsatile and Continuous-Devices
Temporary Devices
TEE Evaluation
Chamber Size and Ventricular Function
Intracardiac Structure and Valvular Function
Inflow and Outflow Cannula Position
Thrombi and Cardiac De-Airing
Effusions
Pulmonary Hypertension
TEE Evaluation
Right Ventricular Function
Estimation of Hemodynamics
Pulmonary Embolism
Role of Echocardiography
TEE Evaluation
Pericardial Diseases
General Considerations
Specific Conditions
Acute Pericarditis
Pericardial Effusion
Constrictive Pericarditis
Pericardial Tumors
TEE Evaluation
Pericardial Effusion and Tamponade Physiology
Evaluation of Constrictive Pericarditis
Aortic Dissection
General Considerations
Classification of Aortic Dissection
TEE Imaging of Thoracic Aorta
Standard Views
Imaging of Aortic Dissection
Cardiac Tumors
General Aspects of the TEE Evaluation
Rhabdomyoma
TEE Evaluation
Fibroma
TEE Evaluation
Myxoma
TEE Evaluation
Other Cardiac Tumors
TEE Evaluation
Summary
Case-Based Examples
Case #1
TEE Findings:
Suggested Reading/References
Case #2
TEE Findings:
Suggested Reading/References
Case #3
TEE Findings:
Suggested Reading/References
Case #4
TEE Findings:
Suggested Readings/References
Case #5
TEE Findings:
Suggested Readings/References
Questions and Answers
References
21: Applications in the Cardiac Catheterization and Electrophysiology Laboratories
Applications in the Cardiac Catheterization and Electrophysiology Laboratories
Introduction
Communication Between Teams
General Concepts
Pre-Procedural Communication (“Time-Out”)
Intra-Procedural Communication
Post-Procedural Communication
Specific Applications of TEE During Interventions for Congenital Heart Disease
Electrophysiologic Studies
Valve Procedures
Septal Interventions: Closure and Creation
Transcatheter Closure of Atrial Septal Defects
Creation or Enlargement of an Atrial Communication
Transcather Occlusion of Ventricular Septal Defects
Baffle Interventions, Closure and Creation
Closure of Fontan Fenestrations or Baffle Leaks
TEE for Guidance of Dilation of Other Congenital Heart Lesions
Summary
References
22: Congenital Heart Disease in the Adult
Indications for TEE in the Adult with CHD
Evaluation of the Patient Prior to TEE
Diastolic Dysfunction
Anatomic Assessment in the Adult Patient with Complex CHD
Thromboembolic Complications
Endocarditis
Prosthetic Valve
Evaluation and Guidance for Transcatheter Interventions
Transcatheter Mitral Valve Repair
Tricuspid Valve
Ruptured Sinus of Valsalva Aneurysm
Ventricular Septal Defect
Left Atrial Appendage Occlusion
Summary
Questions and Answers
References
23: Three-Dimensional Transesophageal Echocardiography in Congenital Heart Disease
Introduction
History and Development
General Concepts
3D TEE Probe Technology
Advantages of Real-Time 3D TEE
3D Image Display
3D TEE for CHD Evaluation
Considerations for 3D TEE in the Evaluation of CHD
Clinical Application for 3D TEE in the Evaluation of CHD
Evaluation of Atrioventricular Valves
Evaluation of Semilunar Valves
Evaluation of Atrial and Ventricular Septal Defects
Evaluation of Other Congenital Cardiac Defects
Further Applications and Development of 3D TEE
3D Imaging: Limitations, Artifacts, and Pitfalls
Summary
Case-Based Examples
Case #1
TEE Findings:
Case #2
TEE Findings:
Case #3
TEE Findings:
Case #4
TEE Findings:
Questions and Answers
References
24: Clinical Applications of Three Dimensional Transesophageal Echocardiography in Congenital Heart Disease
Introduction
Defining Three-Dimensional Cardiac Anatomy
3D TEE Imaging Techniques
Image Display
Guidelines-Based Recommendations
Imaging During Interventional Cath Procedures
Assessment of Surgical Interventions
Imaging Related to Electrophysiology Procedures
Case Examples
Congenitally Corrected Transposition (L-Transposition) of the Great Arteries
Cor Triatriatum
Bicuspid Aortic Valve
Parachute Mitral Valve
Ventricular Septal Defects
Double Inlet Left Ventricle
Atrial Septal Defects
Applications During Interventional Cardiac Catheterization
Transcatheter Closure of Secundum Atrial Septal Defect
Transcatheter Closure of Muscular Ventricular Septal Defect
Surgery for Left Sided Obstructive Lesions
Surgery for Atrioventricular Valves
Right Ventricular to Pulmonary Artery Conduit
Atrial Switch Procedures
Atrial Flutter
Implantable Cardioverter-Defibrillator
Resynchronization Therapy
Tetralogy of Fallot with Melody Valve
Double Outlet Right Ventricle Repair
Congenitally Corrected Transposition Palliated with ASD stent and PA band
Truncus arteriosus
Hypoplastic Left Heart S/P Fontan Procedure
Bioprosthetic Mitral Valve
Congenital Mitral Valve Stenosis
Subaortic Stenosis
Tricuspid Atresia and Extracardiac Fontan
Summary
Questions and Answers
References
Index