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(Chest. 1999;116:1247-1250.)
© 1999 American College of Chest Physicians

Endoscopic Evaluation of the Esophagus in Infants and Children Immediately Following Intraoperative Use of Transesophageal Echocardiography*

Michael A. Greene, MD, FCCP; James A. Alexander, MD, FCCP; Daniel G. Knauf, MD, FCCP; James Talbert, MD; Max Langham, MD; David Kays, MD and Daniel Ledbetter, MD

* From the Divisions of Cardiovascular and Thoracic Surgery (Drs. Greene, Alexander, and Knauf) and Pediatric Surgery (Drs. Talbert, Langham, Kays, and Ledbetter), University of Florida Health Science Center, Gainesville FL.

Correspondence to: Michael A. Greene, MD, FCCP, Surgical Director, Health First Heart Institute, 1055 S. Hickory St #202, Melbourne, FL 32901; e-mail address: mgreene@health-first.org

Objective: Intraoperative transesophageal echocardiography (TEE) has evolved as an essential technique for use during pediatric cardiac surgery; however, few studies have evaluated the safety of TEE in children. This series reports endoscopic examination of the esophagus following intraoperative TEE in pediatric patients.

Methods: Fifty children undergoing congenital heart surgery underwent flexible esophagoscopy that was performed after completion of their heart surgery and after the removal of the transesophageal echo probe. The patients’ ages ranged from 4 days to 10 years old, and their weight ranged from 3.0 to 39.8 kg, with a mean weight of 12.6 kg.

Results: Thirty-two of 50 patients (64%) had abnormal results shown on esophageal examinations; this occurred more frequently in the subset of patients weighing < 9 kg. No long-term feeding or swallowing difficulties were noted in any of the 48 patients who survived.

Conclusions: Intraoperative TEE in infants and children frequently caused mild mucosal injury. Care must be exercised in the insertion and manipulation of the probes.

Key Words: cardiovascular • echocardiography • esophagus




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