Transesophageal and Intraoperative Echocardiography

Transesophageal echocardiography (TEE) in congenital heart disease is possible across the age and size spectrum of almost all patients with congenital heart disease (CHD). Using standard published views as a template, TEE must be adapted to size variation, malposition and abnormalities of connection. A comprehensive sequential examination is used for most elective diagnostic cases but a more targeted approach is generally employed for peri-operative imaging. TEE also is commonly used for pre-intervention assessment as well as for catheter guidance during interventions. Intraoperative echocardiographic (IOE) imaging routinely uses TEE before and/or after CHD surgery. For larger children and adults 3D TEE can be useful. For smaller children and infants direct epicardial echocardiography can be used, particularly for specific lesions where 3D echocardiography is preferred.