ABSTRACT
The development of pediatric transesophageal echocardiography [TEE] represents an important advance in the diagnosis and management of the patient with congenital heart disease. As with TEE a new echocardiographic window is obtained which enable cardiologist to explore the heart from esophagus and stomach. The purpose of this work is evaluation of the role and efficacy of transesophageal echocardiography [TEE] in diagnosis of selected cases of congenital heart disease whether cyanotic or non-cyanotic in the pediatric age group. TEE [biplane 14mm width] was performed in 25 patients at pediatric cardiology unit in Abou El-Rich hospital, Cairo University between December 2003 and December 2004. The mean age of 16 males [64%] and 9 females [36%] patients was 7.1 years. The anaesthetic protocol which used was Ketamine followed by midazolam. The procedure had terminated early in 2 cases only due to O2 desaturation [upper air way obstruction] in one and the other case need over sedation to sleep. TEE proved significant additional in formation in 22 patients [88%], ASD comprised 32%of them and other CHD 86%. TEE proved a more detailed evaluation of the morphology and function of systemic and pulmonary venous return, the atria, inter-atrial baffles, atrio-ventricular valves and the left ventricular outflow tract. Based on our experience the transesophageal echocardiography is safe and reliable but still semi-invasive, it should be done in selected cases of CHD especially cases of ASD to evaluate size of the defect probably