Introduction:
Perioperative TEE is a critically important cardiovascular imaging modality. However, TEE in the pediatric patients became widespread after the introduction of miniaturized probes in the late 1980s.[1] It has a major role in hemodynamic management and detecting residual lesions during and/or after pediatric cardiac surgery. The overall safety profile of TEE probe is quite favourable with a reported incidence of complications is about 1-3%.[2] Athough, the safety of TEE probes has been documented in pediatric patients with small weight, complications such as airway obstruction (1%), right main stem advancement of the endotracheal tube (0.2%), tracheal extubation (0.5%), and vascular compression (0.6%), esophageal perforation and bleeding have been reported.[3] Most of the problems seen in neonates and small infants are associated with respiratory compromise or vascular compression.[4] However, repeated ventricular fibrillation (VF) precipitated by TEE probe has not been described in the literature till date. We hereby report a recurrent and fatal intraoperative VF precipitated by TEE probe in a 2-year-old, 10 kg paediatric patient with OS-ASD, supravalvular PS and severe RV dysfunction.
Key words: Recurrent VF, TEE probe, RV dysfunction, Biphasic DC shock