Low risk of gastroesophageal injury associated with transesophageal echocardiography during cardiac surgery.
Transesophageal echocardiography (TEE) has increasingly been used in cardiology and cardiac surgery with few reported complications. This study was undertaken to determine whether TEE is associated with an increased incidence of gastroesophageal (GE) bleeding or postoperative GE symptoms of anorexia, dysphagia, or sore throat. Forty-one patients who underwent TEE during cardiac surgery and 40 control patients who underwent cardiac surgery without TEE were prospectively followed. In addition, a retrospective chart review of 200 patients who underwent TEE during cardiac surgery was also performed. The following information was derived from the patient interviews and chart reviews: (1) The development of both frank and occult upper gastrointestinal tract (UGI) bleeding; (2) the patient's preoperative anticoagulation status; and (3) the patient's subjective complaints of anorexia, dysphagia, or sore throat. The incidence of postoperative occult or frank UGI bleeding was not increased in the groups who underwent TEE. Additionally, the incidence of postoperative GE symptoms was comparable in the three groups. These findings are discussed in the context of reported complications associated with UGI endoscopy. Based on this analysis, recommendations for the safe performance of TEE have been provided.
Hulyalkar
A R
AR
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD 21205.
Ayd
J D
JD
D000855:Anorexia / Q000209:etiology; D000925:Anticoagulants / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D003680:Deglutition Disorders / Q000209:etiology; D004381:Duodenal Ulcer / Q000150:complications; D004452:Echocardiography / Q000009:adverse effects* / Q000379:methods; D004947:Esophagus / Q000293:injuries*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007430:Intraoperative Care; D008551:Melena / Q000209:etiology; D009780:Occult Blood; D010612:Pharyngitis / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013270:Stomach / Q000293:injuries*; D013997:Time Factors
D000925:Anticoagulants