Transesophageal echocardiography probe insertion failure in infants undergoing cardiac surgery

Shari L. Wellen, Andrew C. Glatz, J. William Gaynor, Lisa M. Montenegro, Meryl S. Cohen

Research output: Contribution to journalArticle

Abstract

Background: The use of intraoperative transesophageal echocardiography (iTEE) in neonates ≤4kg has not been systematically described. We sought to describe the use of and determine risk factors for iTEE probe insertion failure in small infants. We also sought to develop an algorithm for predicting the likelihood of iTEE probe insertion failure. Design: A retrospective chart review of all neonates ≤4kg who underwent cardiac surgery at our institution from 12/2001 to 12/2006 was performed. Patients who underwent operations that did not typically require TEE were excluded. Risk factors for TEE probe insertion failure were assessed. Results: Of 310 neonates who met the inclusion criteria, 219 (70%) underwent successful iTEE. Lower weight (P <.001), abnormal craniofacial anatomy (P =03), prematurity (P =015), and 22q11 deletion (P =04) were independently associated with iTEE probe insertion failure. Stratified by weight, there was an 80% predicted probability of iTEE probe insertion failure for infants weighing: 2kg with any two of the above risk factors and 3kg with any three of the above risk factors. There was less than an 80% predicted likelihood of iTEE probe insertion failure for infants weighing 4kg regardless of other risk factor status. Conclusions: iTEE can be successfully performed in the majority of neonates ≤4kg undergoing cardiac surgery. However, there are identifiable risk factors for iTEE probe insertion failure. A weight-based algorithm may help determine neonates at risk for iTEE probe insertion failure. Smaller TEE probes may benefit this patient population.

Original languageEnglish (US)
Pages (from-to)240-245
Number of pages6
JournalCongenital Heart Disease
Volume8
Issue number3
DOIs
StatePublished - May 1 2013

Keywords

  • Congenital Heart Disease
  • Echocardiography
  • Infant
  • Pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Wellen, S. L., Glatz, A. C., Gaynor, J. W., Montenegro, L. M., & Cohen, M. S. (2013). Transesophageal echocardiography probe insertion failure in infants undergoing cardiac surgery. Congenital Heart Disease, 8(3), 240-245. https://doi.org/10.1111/chd.12027