Predictive value of intraoperative transesophageal echocardiography in complete atrioventricular septal defect

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Kim, Hyun Koo; Kim, Woong-Han; Hwang, Sung Wook; Lee, Jae Young; Song, Jin Young; Kim, Soo-Jin; Jang, Ki Young
Issue Date
Ann Thorac Surg. 2005 Jul;80(1):56-9.
AdolescentAdultCardiac Surgical ProceduresChildChild, Preschool*Echocardiography*Echocardiography, TransesophagealFemaleHeart Septal Defects/complications/*surgeryHeart Valve Diseases/complications/surgery/ultrasonographyHumansInfantIntraoperative PeriodMalePostoperative PeriodPredictive Value of TestsRetrospective StudiesTreatment Outcome
BACKGROUND: Intraoperative transesophageal echocardiography and follow-up transthoracic echocardiography have been useful in assessing cardiac function in complete atrioventricular septal defects. However, it has been suggested that a discrepancy exists between intraoperative and postoperative findings, and that intraoperative findings cannot reliably predict long-term results. This study aims to determine whether this discrepancy exists and to assess whether it is possible to predict follow-up results using intraoperative transesophageal echocardiography. METHODS: A retrospective analysis was made in 35 patients who underwent biventricular repair by one surgeon between November 1997 and January 2004. All patients received intraoperative transesophageal echocardiography and follow-up transthoracic echocardiography at 19.1 +/- 18.02 months (range, 7 days to 5 years; median, 15.1 months). RESULTS: In left-sided atrioventricular valve regurgitation, 34.3% (12 of 35) of patients showed discrepancy during follow-up, and 28.6% (10 of 35) showed progression of regurgitation (from grade I to II). In right-sided atrioventricular valve, 11.4% (4 of 35) of patients showed discrepancy, 9.6% (3 of 35) showed progression of regurgitation (from grade I to II). CONCLUSIONS: In complete atrioventricular septal defects, intraoperative transesophageal echocardiography did not show the same findings as that of follow-up transthoracic echocardiography in some cases. However, this discrepancy is not so great as to require reoperation in early to midterm follow-up. Therefore, intraoperative transesophageal echocardiography may be used as tool to predict durability of surgical results and to decrease the incidence of reoperation in complete atrioventricular septal defects.
1552-6259 (Electronic)
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College of Medicine/School of Medicine (의과대학/대학원)Thoracic Surgery (흉부외과학전공)Journal Papers (저널논문_흉부외과학전공)
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