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