• O Stümper, J Vargas-Barron, M Rijlaarsdam, A Romero, J R Roelandt, J Hess, and G R Sutherland.
• Academic Hospital Rotterdam--Dijkzigt.
• Br Heart J. 1991 Dec 1; 66 (6): 411-8.

ObjectiveTo assess the value of transoesophageal echocardiography in the preoperative definition of systemic and pulmonary venous connections.DesignTransoesophageal echocardiographic studies were performed prospectively under general anaesthesia in 76 consecutive unoperated children. Results were compared with those obtained by earlier transthoracic ultrasound studies (n = 76), cardiac catheterisation (n = 62), and subsequent surgical inspection (n = 58).SettingTwo tertiary referral centres.Patients76 unoperated infants and children (age 0.2-14.8 years, mean age 4.1 years) with congenital heart disease.Main Outcome MeasureIdentification of anomalous systemic and pulmonary venous connections.ResultsTransoesophageal studies showed anomalous venous connections in 14 patients. Two had both anomalous systemic and pulmonary venous connections. Transoesophageal studies showed 12 anomalous systemic venous connections in nine patients. In eight patients these were confirmed at operation or catheterisation: one patient is awaiting operation. Six anomalous systemic venous connections were missed during earlier transthoracic studies. Anomalous pulmonary venous connections (one mixed total, six partial) were shown in seven patients. These were confirmed at operation in six and by cardiac catheterisation in one. Four of these patients were missed during earlier transthoracic ultrasound studies. No patient defined as having normal venous connections by the transoesophageal study was subsequently shown to have anomalous venous connections at operation or angiography.ConclusionsTransoesophageal echocardiography is a highly sensitive tool for the preoperative definition of systemic and pulmonary venous connections. In this series it was better than transthoracic ultrasound and complemented cardiac catheterisation and angiocardiography.

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