Document Detail


Transesophageal echocardiography in critically ill acute postoperative infants: comparison of AcuNav intracardiac echocardiographic and microTEE miniaturized transducers.
MedLine Citation:
PMID:  22749435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multiple barriers to transthoracic echocardiography are present in critically ill infants immediately after surgery. Transesophageal echocardiography (TEE) is sometimes needed to obtain specific important information that transthoracic echocardiography fails to demonstrate. Formerly, the investigators used the AcuNav intracardiac echocardiographic (ICE) intravascular ultrasound transducer (8 Fr, 2.5 mm, 64-element crystal array, multifrequency [5.5-10 MHz], single longitudinal plane, linear phased array [Siemens Medical Solutions USA, Inc., Mountain View, CA]). Recently, the investigators have also used the microTEE transducer (8-mm transducer tip, 5.2-mm shaft, multifrequency [3-8 MHz], multiplane phased array, 32-element probe [Philips Medical Systems, Andover, MA]). Both transducers have two-dimensional, M-mode, color Doppler, and pulsed-wave and continuous-wave Doppler capabilities. The aim of this study was to compare the efficacy, safety, ease of insertion, capabilities, utilization, and cost of the AcuNav ICE transducer versus those of the microTEE transducer.
METHODS: A retrospective review of all 50 postoperative critically ill infants who underwent TEE using the AcuNav and microTEE in the past 5 years was conducted. TEE was performed as ordered by the attending physician to answer a specific question not answered by transthoracic echocardiography.
RESULTS: In all cases, the clinical information sought was obtained. The AcuNav ICE transducer was safe, easy to insert through the transnasal route, and did not require paralysis; however, it had a limited number of echocardiographic views and had greater sterilization cost. The microTEE transducer had greater echocardiographic capabilities and lower sterilization cost; however, it was slightly more difficult to insert, had a few manageable complications, and required more sedation and paralysis.
CONCLUSIONS: TEE in this setting has increased because of demonstrated efficacy and safety. Both the AcuNav ICE and microTEE transducers are useful and effective in this critical clinical scenario.
Authors:
Sunita Ferns; Rukmini Komarlu; Andrew Van Bergen; Kanwar Multani; Vivian Wei Cui; David A Roberson
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2012-06-29
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  25     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-12-18     Revised Date:  2013-02-18    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  874-81     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Affiliation:
Heart Institute for Children, Hope Children's Hospital, Chicago Medical School, Oak Lawn, Illinois 60453, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Cardiovascular Diseases / surgery*,  ultrasonography*
Critical Care
Echocardiography, Transesophageal / instrumentation*,  methods
Endosonography / instrumentation*
Equipment Design
Equipment Failure Analysis
Female
Humans
Infant
Infant, Newborn
Male
Miniaturization
Postoperative Care / methods*
Reproducibility of Results
Sensitivity and Specificity
Transducers*
Treatment Outcome
Comments/Corrections
Comment In:
J Am Soc Echocardiogr. 2013 Jan;26(1):103-4   [PMID:  23261369 ]
J Am Soc Echocardiogr. 2013 Jan;26(1):103   [PMID:  23059370 ]

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