Intraoperative two-dimensional echocardiography in congenital heart disease.

Intraoperative epicardial two-dimensional echocardiography was used in 195 patients undergoing surgery for congenital heart disease to evaluate its potential to identify new diagnostic information immediately before and after surgical correction. In 168 patients the preoperative diagnosis was confirmed by intraoperative echocardiography. In four patients, unsuspected findings were revealed, which resulted in modification of the surgical approach. In 18 patients additional morphologic information was obtained which contributed to alteration or refinement of surgical management. The adequacy of cardiac repair was assessed before closure of the chest in all patients. In six patients this information led to immediate reoperation and in four other patients to inotropic drug therapy. During congenital heart surgery, epicardial two-dimensional echocardiography may yield important information for surgical management. The technique is an essential adjunct when preoperative diagnostic studies are not conclusive or when the initial response to repair is unsatisfactory.