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Circulation. 1991;83:817-821

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Circulation, Vol 83, 817-821, Copyright © 1991 by American Heart Association


ARTICLES

Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations

WG Daniel, R Erbel, W Kasper, CA Visser, R Engberding, GR Sutherland, E Grube, P Hanrath, B Maisch and K Dennig
Division of Cardiology, Hannover Medical School, FRG.

BACKGROUND. During the past few years, transesophageal echocardiography (TEE) has been increasingly used in clinical cardiology; data concerning the practicability and safety of the technique, however, are rare. METHODS AND RESULTS. This report analyzes the experience of 15 European centers performing TEE studies for at least 1 year. At the time of this survey, 10,419 TEE examinations had been attempted or performed in these institutions. These TEE examinations were carried out by 54 physicians, 53.7% of whom had been trained in endoscopic techniques. Within the same time period, 160,431 precordial echocardiographic examinations were performed in the 15 institutions; the ratio between TEE and transthoracic studies averaged 9.03 +/- 6.4% (range of the 15 centers, 1.4-23.6%). Of the 10,419 patients, 9,240 (88.7%) were conscious inpatients or outpatients at the time of the TEE examination; the vast majority of the conscious patients did not receive intravenous sedation before TEE. In 201 cases (1.9%), insertion of the TEE probe was unsuccessfully attempted because of a lack of patient cooperation and/or operator experience (98.5%) or because of anatomical reasons (1.5%). In 90 of 10,218 TEE studies (0.88%) with successful probe insertion, the examination had to be interrupted because of the patient's intolerance of the echoscope (65 cases); because of pulmonary (eight cases), cardiac (eight cases), or bleeding complications (two cases); or for other reasons (seven cases). One of the bleeding complications resulted from a malignant lung tumor with esophageal infiltration and was fatal (mortality rate, 0.0098%). CONCLUSIONS: This multicenter survey documents that TEE studies are associated with an acceptable low risk when used by experienced operators under proper safety conditions.


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NEJMHome page
W. J. Manning, D. I. Silverman, S. Gordon, H. M. Krumholz, and P. S. Douglas
Cardioversion from Atrial Fibrillation without Prolonged Anticoagulation with Use of Transesophageal Echocardiography to Exclude the Presence of Atrial Thrombi
N. Engl. J. Med., March 18, 1993; 328(11): 750 - 755.
[Abstract] [Full Text]


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NEJMHome page
W. G. Daniel
Should Transesophageal Echocardiography Be Used to Guide Cardioversion?
N. Engl. J. Med., March 18, 1993; 328(11): 803 - 804.
[Full Text]


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ANN INTERN MEDHome page
F. A. DeRook, K. A. Comess, G. W. Albers, and R. L. Popp
Transesophageal Echocardiography in the Evaluation of Stroke
Ann Intern Med, December 1, 1992; 117(11): 922 - 932.
[Abstract] [PDF]


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PerfusionHome page
E. A Hessel II
Review article : What's new in monitoring the coronary surgery patient?
Perfusion, July 1, 1992; 7(3): 161 - 194.
[Abstract] [PDF]


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ANN INTERN MEDHome page
P. A. Tunick, J. L. Perez, and I. Kronzon
Protruding Atheromas in the Thoracic Aorta and Systemic Embolization
Ann Intern Med, September 15, 1991; 115(6): 423 - 427.
[Abstract] [PDF]


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JWatch GeneralHome page
TRANSESOPHAGEAL ECHOCARDIOGRAPHY IS A LOW-RISK PROCEDURE
Journal Watch (General), March 19, 1991; 1991(319): 7 - 7.
[Full Text]


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CirculationHome page
P. S. Wild and R. J. Zotz
Fragment Reconstruction of Coronary Arteries by Transesophageal Echocardiography: A Method for Visualizing Coronary Arteries With Ultrasound
Circulation, April 2, 2002; 105(13): 1579 - 1584.
[Abstract] [Full Text] [PDF]