Epicardial Echocardiography

The technique converts echoes from cardiac structures into two-dimensional images, while Doppler measurements characterize blood flow. Imaging directly at the epicardial surface reduces interference from the chest wall, lungs, and surgical materials, so clinicians can examine anatomy and function during an operation. This combination supports assessment of ventricular performance and valve behavior while repairs are still accessible.

Doppler provides measurements of blood flow that complement the anatomic information in two-dimensional images. These measurements help evaluate valve performance and contribute to assessment of cardiac function after or during a repair. Using both image formation and flow measurement allows clinicians to examine whether the repaired heart is functioning appropriately before the operation is completed.

Direct contact with the exposed heart avoids structures that can interfere with ultrasound assessment, including the chest wall, lungs, and surgical materials. Removing these barriers can improve visualization of cardiac anatomy and function during surgery. The clearer view is particularly useful when clinicians need to inspect a repair, identify a remaining abnormality, or make an immediate surgical decision.

A sterile ultrasound transducer provides the interface for acquiring images and Doppler measurements from the heart’s surface during an operation. Its placement on the exposed epicardium permits assessment while maintaining the intraoperative setting. The resulting information can be used to evaluate anatomy, blood flow, valve performance, and ventricular function before the chest is closed.

After a cardiac repair, clinicians can use the technique to examine the relevant anatomy, evaluate blood flow and valve performance, and assess ventricular function. They can also look for residual defects that may require attention. Because this assessment occurs before closing the chest, its findings can guide further surgical decisions and help verify the immediate result.

The method is especially relevant to congenital, valvular, and complex cardiac surgery. In these settings, clinicians may need detailed intraoperative information about repaired anatomy, valve behavior, blood flow, or ventricular performance. Direct imaging helps assess whether the intended correction has been achieved and whether any residual defect remains before the procedure is concluded.

Intraoperative findings can show whether a repair has left a residual defect, whether valve performance is satisfactory, and how well the ventricles are functioning. They also provide information for immediate surgical decision-making rather than relying only on assessment after closure. This makes the technique useful for verifying outcomes while corrective changes may still be possible.