کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
2977889 | 1179507 | 2016 | 6 صفحه PDF | دانلود رایگان |
کلمات کلیدی
مقدمه
شکل ۱. تغییرات از تشخیص اولیه در TTE پیش از عمل
مواد و روش ها
شکل ۲. ضایعات باقی مانده در پژواک نگاری قلبی
جدول ۱. تشخیص و جراحی اصلاحی برای هر تشخیص
جدول ۲. اثر وزن و سن بروی نوع پژواک نگاری پیش از جراحی
جدول ۳. رویه های اصلاحی
جدول ۴. تغییر TTE (پژواک نگاری قلبی ترانسفاژیال پیش از جراحی) از تشخیص TTE (پژواک نگاری قلبی Transthoracic پیش از جراحی
جدول ۵. تغییرات در پژواک نگاری قلبی Transthoracic پیش گیرانه (TTE) از پژواک نگاری قلبی ترانسفاژیال پس از جراحی
نتایج
مباحثه
جمع بندی (نتیجه گیری)
BackgroundIntraoperative transesophageal echocardiography (TEE) has a major role in detecting residual lesions during and/or after pediatric cardiac surgery.MethodsAll pediatric patients who underwent cardiac surgery between July 2001 and December 2008 were reviewed. The records of surgical procedure, intraoperative TEE, and predischarge transthoracic echocardiograms were reviewed to determine minor and major residual cardiac lesions after surgical repair.ResultsDuring the study period, a total of 2268 pediatric cardiac patients were operated in our center. Mean age was 21 months (from 1 day to 14 years). Of these patients, 1016 (48%) had preoperative TEE and 1036 (46%) were evaluated by intraoperative echocardiography (TEE or epicardial study). We identified variations between TEE and preoperative transthoracic echocardiography in 14 patients (1.3%). Only one surgical procedure was cancelled after atrial septal defect exclusion. The other 13 patients had minor variation from their surgical plan. Major residual lesions requiring surgical revision were detected in 41 patients (3.9%), with the following primary diagnoses: tetralogy of Fallot in 12 patients (29%), atrioventricular septal defect in seven patients (17%), ventricular septal defect in seven patients (17%), double outlet right ventricle in two patients (5%), Shone complex in two patients (5%), subaortic stenosis in two patients (5%), mitral regurgitation in two patients (5%), pulmonary atresia in two patients (5%), and five patients (12%) with other diagnoses.ConclusionIntraoperative TEE has a major impact in pediatric cardiac surgery to detect significant residual lesions. Preoperative TEE has a limited role in case of a high quality preoperative transthoracic echocardiography. We recommend routine use of intraoperative TEE during and/or after intracardiac repair in children.
Journal: Journal of the Saudi Heart Association - Volume 28, Issue 2, April 2016, Pages 89–94