Literature DB >> 19058977

Major complications related to the use of transesophageal echocardiography in cardiac surgery.

Mathew Piercy1, Larry McNicol, Diem T Dinh, David A Story, Julian A Smith.   

Abstract

OBJECTIVE: The purpose of this study was to determine the incidence of injury associated with transesophageal echocardiography (TEE injuries) in cardiac surgery.
DESIGN: Retrospective.
SETTING: University-affiliated hospitals. PARTICIPANTS: Four thousand seven hundred eighty-four patients, 89% of all public hospital cardiac surgery patients in Victoria, from the Australasian Society of Cardiac and Thoracic Surgeons (ASCTS) database undergoing cardiac surgery with TEE between July 1, 2005, and June 30, 2007. Because ASCTS did not record TEE use before July 2005, it was assumed that 89% of an additional 11,719 cardiac surgery patients between July 2001 and June 2005 also had TEE.
INTERVENTIONS: The authors searched the ASCTS database for cardiac surgery patients who also had endoscopy and/or noncardiac surgery. The files of these patients were screened for possible esophageal or gastric tears or perforations. An expert panel determined likely TEE injuries.
MEASUREMENTS AND MAIN RESULTS: There were 6 TEE complications from July 1, 2005, to June 30, 2007 (13/10,000 patients). There were a further 8 TEE complications before June 30, 2005, an extrapolated overall rate of 9/10,000 TEE (95% confidence interval, 5-16/10,000). TEE complications were more frequent in patients more than 70 years old (relative risk [RR], 3.7; p = 0.03) and women (RR, 6.5; p < 0.001). Three patients with TEE injury died (2/10,000).
CONCLUSIONS: TEE is associated with an incidence of major injuries of about 1 per 1,000 patients, with older women having a much higher risk. TEE use in cardiac surgery should be evaluated in the light of practice guidelines and morbidity and mortality data and not considered routine.

Entities:  

Mesh:

Year:  2008        PMID: 19058977     DOI: 10.1053/j.jvca.2008.09.014

Source DB:  PubMed          Journal:  J Cardiothorac Vasc Anesth        ISSN: 1053-0770            Impact factor:   2.628


  20 in total

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5.  Emergent limited perioperative transesophageal echocardiography: should new guidelines exist for limited echocardiography training for anesthesiologists?

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Review 7.  Point of care cardiac ultrasound applications in the emergency department and intensive care unit--a review.

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8.  Transesophageal Echocardiography in Patients Undergoing Coronary Artery Bypass Graft Surgery.

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9.  Usefulness and growing need for intraoperative transthoracic echocardiography: a case series.

Authors:  Kotaro Hori; Tadashi Matsuura; Takashi Mori; Kiyonobu Nishikawa
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10.  Complications related to intraoperative transesophageal echocardiography in liver transplantation.

Authors:  Sher-Lu Pai; Stephen Aniskevich; Neil G Feinglass; Beth L Ladlie; Claudia C Crawford; Prith Peiris; Klaus D Torp; Timothy S Shine
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