Does intraoperative epicardial echocardiography accurately detect residual lesions compared to postoperative transthoracic echocardiography in patients undergoing surgical repair of congenital heart defects?
Intraoperative epicardial echocardiography is a highly specific and sensitive tool for detecting residual lesions during congenital heart surgery, allowing for immediate surgical revision and potentially avoiding the need for transesophageal echocardiography in small children.
OBJECTIVE: To determine the accuracy of epicardial echocardiography in detecting residual lesions after surgical repair of congenital heart defects. To determine the sensitivity, specificity, positive predictive valve, negative predictive valve, and false negative and false positive percentage of the same. MATERIALS AND METHODS: One year hospital-based prospective study of epicardial echocardiography in patients undergoing cardiopulmonary bypass for surgical correction of congenital heart defects in children and adults. RESULTS: Epicardial echocardiography was done in 158 patients. Residual lesions were detected in 38 patients by epicardial echocardiography. In 28 of these cases the residual lesions were significant. In 24 of them immediate reoperation was done with good outcome. Epicardial echo has high sensitivity, specificity, positive and negative predictive valve, in detecting residual lesion with congenital heart defects. CONCLUSION: Routine use of intraoperative epicardial echocardiography allows detection of majority of residual defects. It has high accuracy. There were no complications associated with use of epicardial echocardiography. The use of transesophageal echocardiography (TEE) can be avoided in small children and neonates undergoing cardiac surgery.
Manvi et al. (Tue,) studied this question.