title: Safety of transesophageal echocardiography.
abstract: Since its introduction into the operating room in the early 1980s, transesophageal echocardiography (TEE) has gained widespread use during cardiac, major vascular, and transplantation surgery, as well as in emergency and intensive care medicine. Moreover, TEE has become an invaluable diagnostic tool for the management of patients with cardiovascular disease in a nonoperative setting. In comparison with other diagnostic modalities, TEE is relatively safe and noninvasive. However, the insertion and manipulation of the ultrasound probe can cause oropharyngeal, esophageal, or gastric trauma. Here, the authors review the safety profile of TEE by identifying complications and propose a set of relative and absolute contraindications to probe placement. In addition, alternative echocardiographic modalities (e.g., epicardial echocardiography) that may be considered when TEE probe placement is contraindicated or not feasible are discussed.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. jhilberath@partners.org
authors.forename: Jan N
authors.initials: JN
authors.lastname: Hilberath
authors.forename: Daryl A
authors.initials: DA
authors.lastname: Oakes
authors.forename: Stanton K
authors.initials: SK
authors.lastname: Shernan
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Bulwer
authors.forename: Michael N
authors.initials: MN
authors.lastname: D'Ambra
authors.forename: Holger K
authors.initials: HK
authors.lastname: Eltzschig
mesh_terms: D006348:Cardiac Surgical Procedures; D017548:Echocardiography, Transesophageal / Q000009:adverse effects* / Q000379:methods; D004939:Esophageal Perforation / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment; D017751:Safety Management