Clinical application of a micro multiplane transoesophageal probe in congenital cardiac disease

Abstract

To assess the quality of imaging modalities of a new micro multiplane transoesophageal echocardiogram probe. This is a prospective study of micro transoesophageal echocardiogram S8-3t probe used at a single institution between 15 December, 2009 and 15 March, 2010. The images were compared with standard paediatric or adult probes where possible. Assessors prospectively rated imaging quality - two dimensional, colour flow imaging, pulse wave, and continuous wave Doppler - with a subjective 4-point scale (1 = poor to 4 = excellent). A total of 24 studies were performed on 23 patients, with a median weight = 11.7 kilograms (2.6-72 kilograms) and a median age of 3 years (0.16-60 years). Of the 23 patients, one neonate (2.8 kilograms) had transient bradycardia on probe insertion. Imaging in patients less than 10 kilograms was of full diagnostic value and new information was obtained in eight out of ten patients. Pulse wave and continuous wave Doppler was consistently good across all weight groups. There were high frame rates and good imaging quality to a depth of 4-6 centimetres in all studies. A comparison with a larger alternative probe was available for 12 studies (weight 11.9-72 kilograms). The median micro transoesophageal two-dimensional image quality score was 3 (2-4) and 4 (3-4) with the comparative probe. For the 10- to 30-kilogram group, image quality with the micro transoesophageal echocardiogram probe was judged as inferior to larger standard probes. Adult sized patients had good imaging of near the field, allowing guidance for percutaneous device closure of the atrial septum. The micro multiplane transoesophageal echocardiogram probe provides imaging of diagnostic quality in neonates. In larger patients, it offers good imaging of near field structures. In the intermediate-sized child (10-30 kilograms), standard paediatric probes provide better imaging.