Transesophageal echocardiography-related complications

Côté, Geneviève; Denault, André

doi:10.1007/bf03021437

Cited by 102 publications

(55 citation statements)

References 193 publications

(191 reference statements)

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“…Risk factors that can precipitate gastric bleeding caused by TEE following cardiac surgery include a previous ulcerative process, vasoactive drug utilization, and absence of H2 antagonist in the perioperative period. Other factors such as a long CPB period, urgent surgery, reoperation, or aspirin use have also been implicated [13].…”

Section: Discussionmentioning

confidence: 99%

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Gastric bleeding detected by transesophageal echocardiography during cardiopulmonary bypass

et al. 2010

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Gastric bleeding during cardiopulmonary bypass (CPB) is a rare but life-threatening complication for patients undergoing cardiac surgery. We present a case of a patient undergoing coronary bypass grafting in whom we detected gastric bleeding by transesophageal echocardiography (TEE) during CPB. After separation from CPB, bleeding was stopped by endoscopic clipping of the mucosa. If a fluid deficit is noted and TEE reveals a hypoechoic space within the stomach, gastric bleeding might be suggested.

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Section: Discussionmentioning

confidence: 99%

“…In previous reports, patients with gastrointestinal bleeding were treated successfully by conservative histamine-2 receptor antagonist therapy [4,13]. De Vries et al successfully stopped massive bleeding using iced saline gastric lavage and endoscopic infiltration of 5 ml adrenaline solution (100 lg ml -1 ) for bleeding [16].…”

Section: Discussionmentioning

confidence: 99%

Gastric bleeding detected by transesophageal echocardiography during cardiopulmonary bypass

et al. 2010

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“…The benefits of peri-operative echocardiography should therefore be weighed against the risks that it poses. (84) There are few absolute contra-indications. Recent oesophageal surgery, oesophageal strictures, diverticulae and tumours will be contra-indications.…”

Section: Complications and Contra-indicationsmentioning

confidence: 99%

The role of peri-operative transoesophageal echocardiography

Swanevelder

2017

SAHJ

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The role of peri-operative transoesophageal echocardiography cardiovascular surgery. (5,6,7,8,9,10) More recent retrospective analyses of prospectively collected data suggest that around 5.6% of surgical procedures are altered on the basis of intra-operative echocardiographic findings and that there are cost-benefit savings particularly during combined valve and graft operations. (11,12,13) Recently, the roles for peri-operative echocardiography have also extended to include intensive care (14,15) and non-cardiac surgery. (16,17,18) Although it is complex to scientifically prove the benefits of a diagnostic monitor, TOE has been shown to strongly influence intra-operative anaesthetic decisions, particularly in patients with increased risk factors for haemodynamic instability or myocardial ischaemia. In a prospective observational case series of 98 patients undergoing abdominal surgery, the judgement of the anaesthetists was that TOE led to useful alterations in intraoperative care such as administration of fluids, vasoactive drugs and β blockers. In some patients, use of the pulmonary artery catheter was obviated. (19) Similarly, in another case series comprising 90 patients undergoing vascular, visceral and chest surgery, TOE directed changes in drug (47%) and fluid therapy (24%). PERI-OPERATIVE TOE IntroductIonIn 1976 transoesophageal echocardiography (TOE) was introduced into clinical practice.(1) Within a decade, its use extended from cardiology departments into the cardiac surgical arena. However,at that time few probes were available for the operating theatre.Indeed in a report from the United States in 1988, only about 50 TOE probes were accessible for intra-operative use.(2) Furthermore, despite its utility for cardiac surgery, it became evident that few cardiologists were able to spend long periods in the operating theatre. Over time much enthusiasm and expertise for TOE has developed amongst cardiac anaesthesiologists, and by 2001, 94%of respondents in a survey of the Society of CardiovascularAnaesthesiologists utilised intra-operative echocardiography in their routine practice.Over the past 30 years technology has improved tremendously and intra-operative TOE has become an established imaging modality and the gold standard intra-operative cardiac monitor and diagnostic tool in certain cardiac procedures, e.g. mitral valve repair, congenital heart surgery, etc. IndIcAtIons And PrActIcE guIdElInEsEarly experience with the use of peri-operative echocardiography was obtained from its application in cardiac anaesthetic practice; recently however, its role has extended to include non-cardiac surgery and intensive care. Category I indications are supported by strong evidence and expert opinion that TOE is indicated, very useful and will improve patient outcome. These category I indications encompass the everyday practice of the intra-operative anaesthetist-echocardiographer and will be discussed in more detail in this review.Category II indications are supported by weaker evidence and less expert opinion ...

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“…First, TEE is a semi-invasive method, associated with life-threatening complications (laryngospasm, arrhythmias, oesophagus perforation, bleeding) in 1-3% of cases [46]. Second, compared to TTE, it is much more wasteful of resources, requiring expensive equipment and specially trained personnel.…”

Section: Blood Flow Patterns and Risk Stratificationmentioning

confidence: 99%