The safety of intraoperative transesophageal echocardiography: A case series of 7200 cardiac surgical patients

Transesophageal echocardiography (TEE) is an invaluable intraoperative diag nostic monitor that is considered to be relatively safe and noninvasive. In sertion and manipulation of the TEE probe, however, may cause oropharyngeal , esophageal, or gastric trauma. We report the incidence of intraoperative TEE-associated complications in a single-center series of 7200 adult cardia c surgical patients. Information related to intraoperative TEE-associated c omplications was obtained retrospectively from the intraoperative TEE data form, routine postoperative visits, and cardiac surgical morbidity and mort ality data. The overall incidences of TEE-associated morbidity and mortalit y in the study population were 0.2% and 0%, respectively. The most common T EE-associated complication was severe odynophagia, which occurred in 0.1% o f the study population. Other complications included dental injury (0.03%), endotracheal tube malpositioning (0.03%), upper gastrointestinal hemorrhag e (0.03%), and esophageal perforation (0.01%). TEE probe insertion was unsu ccessful or contraindicated in 0.18% and 0.5% of the study population, resp ectively. These data suggest that intraoperative TEE is a relatively safe d iagnostic monitor for the management of cardiac surgical patients.