Application of intraoperative transesophageal echocardiography in infants and small children

Intraoperative echocardiography is gaining increasing acceptance in the assessment of the surgical repair of congenital heart defects. Because of its ideal imaging location, intraoperative transesophageal echocardiography (TEE) has been especially helpful in evaluating pulmonary venous return and the integrity of the left atrioventricular valve following mitral valvuloplasty, complete atrioventricular valve repair and correction of complex congenital heart disease. It has not been routinely used in infants and small children because of a prohibitively large probe size. We report the successful use of a recently developed 'pediatric' TEE probecapable of Doppler and color flow imaging in two patients less than 7 years of age. No complications were encountered. Recommendations regarding optimal probe imaging positions in infants are provided.