**5.1.6 Echocardiography**

Intraoperative transesophageal echocardiography (TEE) plays a critical role in improving surgical outcome in CHD surgeries by confirming diagnosis and identifying residual defects. It is also helpful in the placement of devices in catheterization lab. Micromultiplane TEE probe and three dimensional technologies are new advances in echocardiography. Epicardial echocardiography is an alternative option in institutions where smaller TEE probe is not available18. Adult TEE probe can be used in patient weighing more than 20Kg.

Arterial blood gases and blood glucose should also be done frequently. Tight blood glucose control is suggested by certain authors as high blood sugar is toxic to mitochondria.

#### **Intraoperative management**

Anaesthetic management during surgery depends on presence or absence of shunt, pulmonary hypertension, hypoxaemia, Ventricular dysfunction, pulmonary flow and arrhythmia.
