We present our experience of intraoperative transesophageal echocardiography (TEE)in children weighing less than 5 kg. 70 infants weighing less than 5 kg underwent surgical repair during last one year. Intraoperative TEE was planned in 48 infants. Mean age of the patients was 3.1 +/- 2.6 months and weight ranged from 2.28 to 5 kg( mean of 3.76kg). TEE examination was performed using pediatric TEE probe with Vivid I (GE)echocardiography equipment. Successful intraoperative TEE could be performed in 42 patients. TEE probe could not be inserted in 4 patients due to retrognathia. TEE probe had to be removed in 2 patients prior to imaging due pulmonary hypertensive crisis in patients with obstructed total anomalous pulmonary venous connection. There were no complications like eosophageal tear or bleeding. The mean airway pressure increased by 3 mm H2O in 12 childrean and mean arterial pressure increased by 5 mm Hg in 5 children after removing probe who were weighing less than 3 Kg. 4 children needed revision of surgical repair in 4 children due to residual defects. One patient needed closure of residual VSD, two needed revision of anastomosis in patients with repair of total anomalous pulmonary venous connection and one had anastomosis narrowing after arterial switch repair which needed revision.
We conclude that infants weighing less than 5 kg can safely undergo intraoperative TEE without major complications. Patients in this age group present with complex intracardiac defects which need early repair. Use of intraopeartive TEE will help to minimise the residual defects.