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Added Value of Live 3-Dimensional Transesophageal Echocardiography During Procedures in Fontan Patients

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Abstract

3D transesophageal echocardiography (3D-TEE) has proven useful and accurate during some operating room (OR), interventional cardiac catheterization (Cath), and electrophysiologic (EP) procedures. The use of 3D-TEE during similar procedures in patients who have undergone Fontan surgery and its additional value have not been previously reported. To determine if live 3D-TEE during procedures post Fontan has added value, 3D-TEEs in 58 post-Fontan patients over a 5-year study period were reviewed. Additional information provided by 3D-TEE (over 2D-TEE) was classified into the following: A: new information which changed/refined the plan and 0: no new important information. Pre- and post-bypass OR 3D-TEEs were counted as one study. A total of 67 3D-TEEs (41 Cath, 13 OR, and 13 EP procedures) were performed. Median age was 14 years (6–39 years). Median weight was 47 kg (21–109 kg). In Cath procedures, only 2/41 (5%) were graded A (R to L atrial level shunt [Fontan leak], n = 1; thrombus in pulmonary artery stump, n = 1). In the OR, 6/13 (46%) were graded A (atrioventricular valvuloplasty, n = 1; neo-aortic valvuloplasty, n = 1; relief of systemic and pulmonary venous outflow obstruction, n = 2 and n = 2; respectively). In EP procedures, 4/13 (31%) were graded A (thrombus, n = 3; mapping for lead placement to assist in multisite pacing for dyssynchrony, n = 1). 3D-TEE of Fontan improved visualization and frequently added value in the OR/EP lab and may be helpful in select catheterization cases. Future studies with a larger sample could build on this data to identify when 3D-TEE will be most useful.

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References

  1. Van Dorn CS, Johnson JT, Hoffman JL (2015) Lifetime cardiac reinterventions following the Fontan procedure. Pediatr Cardiol 36:329–334

    Article  Google Scholar 

  2. Seliem MA, Fedec A, Szwast A et al (2007) Atrioventricular valve morphology and dynamics in congenital heart disease as imaged with real-time 3-dimensional matrix array echocardiography: comparison with 2-dimensional imaging and surgical findings. J Am Soc Echocardiogr 20(7):869–876

    Article  Google Scholar 

  3. Lee AP, Lam YY, Yip GW, Lang RM, Zhang Q, Yu CM (2010) Role of real time three-dimensional transesophageal echocardiography in guidance of interventional procedures in cardiology. Heart 96(18):1485–1493. https://doi.org/10.1136/hrt.2009.190025

    Article  PubMed  Google Scholar 

  4. Anwar AM, Nosir YF, Alasnag M, Chamsi-Pasha H (2014) Real time three-dimensional transesophageal echocardiography: a novel approach for the assessment of prosthetic heart valves. Echocardiography 31(2):188–196. https://doi.org/10.1111/echo.12327

    Article  PubMed  Google Scholar 

  5. Tanis W, Teske AJ, van Herwerden LA, Chamuleau S, Meijboom F, Budde RP, Cramer MJ (2015) The additional value of three-dimensional transesophageal echocardiography in complex aortic prosthetic heart valve endocarditis. Echocardiography 32(1):114–125. https://doi.org/10.1111/echo.12602

    Article  PubMed  Google Scholar 

  6. Goebel B, Wieg S, Hamadanchi A, Otto S, Jung C, Kretzschmar D, Figulla HR, Christian Schulze P, Poerner TC (2016) Interventional left atrial appendage occlusion: added value of 3D transesophageal echocardiography for device sizing. Int J Cardiovasc Imaging 32(9):1363–1370

    Article  Google Scholar 

  7. Dumaswala B, Dumaswala K, Hsiung MC, Quiroz LD, Sungur A, Escanuela MG, Mehta K, Oz TK, Bhagatwala K, Karia NM, Nanda NC (2013) Incremental value of three-dimensional transesophageal echocardiography over two-dimensional transesophageal echocardiography in the assessment of Lambl's excrescences and nodules of Arantius on the aortic valve. Echocardiography 30(8):967–975. https://doi.org/10.1111/echo.12310

    Article  PubMed  Google Scholar 

  8. Joshi D, Bicer EI, Donmez C, Hsiung MC, Nanda NC, Sadat K, Sudhakar S, Ibrahim H, Pandey A, Karia N, Bhagatwala K, Yin WH, Wei J, Chang CY, Chung YC, Tsai SK, Dumaswala B, Dumaswala K (2012) Incremental value of live/real time three-dimensional transesophageal echocardiography over the two-dimensional technique in the assessment of aortic aneurysm and dissection. Echocardiography 29(5):620–630. https://doi.org/10.1111/j.1540-8175.2012.01715.x

    Article  PubMed  Google Scholar 

  9. Mercer-Rosa L, Seliem MA, Fedec A et al (2006) Illustration of the additional value of real-time 3-dimensional echocardiography to conventional transthoracic and transesophageal 2-dimensional echocardiography in imaging muscular ventricular septal defects: does this have any impact on individual patient treatment? J Am Soc Echocardiogr 19(12):1511–1519

    Article  Google Scholar 

  10. Sungur A, Hsiung MC, Meggo Quiroz LD, Oz TK, Haj Asaad A, Joshi D, Dönmez C, Güvenç TS, Nanda NC (2014) The advantages of live/real time three-dimensional transesophageal echocardiography in the assessment of tricuspid valve infective endocarditis. Echocardiography 31(10):1293–1309. https://doi.org/10.1111/echo.12785

    Article  PubMed  Google Scholar 

  11. Hansalia S, Biswas M, Dutta R, Hage FG, Hsiung MC, Nanda NC, Singh P, Manda J, Kesanolla SK, Wei J, Yin WH (2009) The value of live/real time three-dimensional transesophageal echocardiography in the assessment of valvular vegetations. Echocardiography 26(10):1264–1273. https://doi.org/10.1111/j.1540-8175.2009.01042.x

    Article  PubMed  Google Scholar 

  12. Yong MS, Saxena P, Killu AM, Coffey S, Burkhart HM, Wan SH, Malouf JF (2015) The preoperative evaluation of infective endocarditis via 3-dimensional transesophageal echocardiography. Tex Heart Inst J 42(4):372–376. https://doi.org/10.14503/THIJ-14-4375

    Article  PubMed  PubMed Central  Google Scholar 

  13. Johri AM, Witzke C, Solis J, Palacios IF, Inglessis I, Picard MH, Passeri JJ (2011) Real-time three-dimensional transesophageal echocardiography in patients with secundum atrialseptal defects: outcomes following transcatheter closure. J Am Soc Echocardiogr 24(4):431–437. https://doi.org/10.1016/j.echo.2010.12.011

    Article  PubMed  Google Scholar 

  14. Roberson DA, Cui VW (2014) Three-dimensional transesophageal echocardiography of atrial septal defect device closure. Curr Cardiol Rep 16(2):453. https://doi.org/10.1007/s11886-013-0453-4

    Article  PubMed  Google Scholar 

  15. La Canna G, Arendar I, Maisano F, Monaco F, Collu E, Benussi S, De Bonis M, Castiglioni A, Alfieri O (2011) Real-time three-dimensional transesophageal echocardiography for assessment of mitral valve functional anatomy in patients with prolapse-related regurgitation. Am J Cardiol 107(9):1365–1374. https://doi.org/10.1016/j.amjcard.2010.12.048

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Advocate Children’s Hospital, Chicago, IL, USA

    S. Javed Zaidi, Jamie Penk, Lorene Schweig, Vivian W. Cui, Waseem Cossor & David A. Roberson

  2. Department of Pediatric Cardiology, Advocate BroMenn Medical Center, Normal, IL, 61761, USA

    S. Javed Zaidi

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  1. S. Javed Zaidi
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  2. Jamie Penk
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  3. Lorene Schweig
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  4. Vivian W. Cui
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  5. Waseem Cossor
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Correspondence to S. Javed Zaidi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was not obtained from all individual participants as this was a retrospective study. This study was approved by the institutional IRB. Diligent measures were taken to maintain patient confidentiality.

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Zaidi, S.J., Penk, J., Schweig, L. et al. Added Value of Live 3-Dimensional Transesophageal Echocardiography During Procedures in Fontan Patients. Pediatr Cardiol 41, 1370–1375 (2020). https://doi.org/10.1007/s00246-020-02388-x

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