New Technology Intraoperative echocardiography is now firmly established in the field, having been shown to yield information on adequacy of repair, previously missed diagnoses and any need for further procedures. Whereas images were originally obtained most often from the epicardial surface, miniaturization of equipment has now progressed to allow transesophageal echocardiography even in infants. The question of which personnel will interpret these images has arisen. Surgeons and anesthesiologists add their clinical input to the echo interpretation, and all come to agreement on the best course of action. The practice of pediatric cardiovascular anesthesia is also being altered by the development of interventional cardiology .
Several devices allow specially trained cardiologists to treat many common defects without surgery.
Now we also are seeing devices to close holes such as atrial septal defects in the catheterization laboratory. Shorter hospital stays and minimal discomfort are among the advantages touted. Whether anesthesiologists will attend these procedures as they would have in the operating room remains to be seen. Also, in our practice, more than half of our patients either have no insurance or are Medicaid recipients. There is a connection between congenital heart disease and youth, poverty and poor prenatal care, and this relationship further affects reimbursement patterns.