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New imaging breakthrough for pediatric cardiac patients

Imaging tool allows doctors to detect serious residual holes in the heart of pediatric patients during open heart surgery.

By
Amy Wallace
Doctors at Children's Hospital of Philadelphia are using a new imaging tool during surgery to repair congenital heart defects in children to detect serious residual holes in the heart. geralt/PixaBay
Doctors at Children's Hospital of Philadelphia are using a new imaging tool during surgery to repair congenital heart defects in children to detect serious residual holes in the heart. geralt/PixaBay

PHILADELPHIA, Dec. 19 (UPI) -- A new imaging tool is allowing doctors to detect and repair serious residual holes in the heart that can develop during surgery to repair other heart defects in children.

The transesophageal echocardiography, or TEE, is being used by pediatric cardiac surgeons at Children's Hospital of Philadelphia to detect intramural ventricular septal defects, which are holes between two chambers of the heart, that can develop during surgery to repair congenital heart defects.

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Conotruncal defects, a common form of congenital heart defects in children, impact the heart's outflow tracts or pathways that carry blood from the heart to connected arteries resulting in abnormal blood circulation, which can lead to a variety of health problems.

Often during surgery to repair conotruncal defects in children with congenital heart disease, surgeons sew a patch from the ventricle to one of the outflows. However, a residual hole may occur around the patch allowing blood to flow into the right ventricle, a potentially life-threatening complication.

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Prior to the use of TEE, this residual hole was not detected until surgery was complete and may have resulted in a second surgery to repair. With the new imaging tool, doctors can see if a hole develops during surgery and immediately repair it before the surgery is ended.

"We focused on intramural ventricular septal defects, which are holes between to chambers of the heart," Dr. Meryl S. Cohen, senior author and pediatric cardiologist at CHOP said in a press release. "These defects which can occur after initial surgery for another defect, can increase the risk of complications and mortality in children with heart disease, so using imaging tools to quickly identify these defects can improve our care of these children."

The study was the first of its kind to compare the TEE with transthoracic enchocardiography, which is a type of imaging done after surgery.

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Of the 337 patients in the study, 34 had intramural VSDs and both TEE and TTE were used during surgery. The data showed that 19 VSDs were detected with both TEE and TTE, while 15 VSDs were intentified by TTE alone and TEE had 56 percent sensitivity and 100 percent specificity in identifying VSDs.

The study was published in the Journal of Thoracic and Cardiovascular Surgery.

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