Authors :
Dr. SK Asim Ali; Dr. Sanjeeta Umbarkar
Volume/Issue :
Volume 10 - 2025, Issue 9 - September
Google Scholar :
https://tinyurl.com/72cxrxay
Scribd :
https://tinyurl.com/ye859sxw
DOI :
https://doi.org/10.38124/ijisrt/25sep570
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Note : Google Scholar may take 30 to 40 days to display the article.
Abstract :
Background
Transesophageal echocardiography (TEE) has become an indispensable diagnostic and monitoring tool in cardiac surgery,
yet its semi-invasive nature is associated with complications and limitations. Understanding these risks is crucial for safe clinical
practice.
Objective
To review the potential complications, contraindications, limitations, and pitfalls of TEE in cardiac surgery and to provide
a balanced appraisal of its utility in perioperative management.
Methods
Literature-based review of complications, contraindications, and limitations related to TEE, supported by evidence from
large case series and guideline documents. Clinical data were synthesized from key published studies and institutional
experiences.
Results
Major complications of TEE are rare, ranging from 0.2% to 0.5% in diagnostic settings, with mortality below 0.01%.
Intraoperative use increases complication risk (0.2–1.2%), including esophageal trauma, arrhythmias, airway obstruction, and
hemodynamic compromise. Pediatric patients present additional risks due to anatomical constraints. Contraindications include
esophageal pathologies and recent upper GI surgery. Limitations include restricted visualization of certain cardiac structures
and artifacts that may mimic pathology.
Conclusion
Despite its risks, TEE remains an essential perioperative tool in cardiac surgery. Awareness of its complications and
limitations allows clinicians to optimize patient safety while benefiting from its diagnostic power.
Keywords :
Transesophageal Echocardiography, Cardiac Surgery, Complications, Limitations, Perioperative Monitoring.
References :
- Hilberath JN, Oakes DA, Shernan SK, et al. Safety of transesophageal echocardiography. J Am Soc Echocardiogr. 2010; 23:1115-27.
- Kallmeyer IJ, Collard CD, Fox JA, et al. The safety of intraoperative transesophageal echocardiography: a case series of 7200 cardiac surgical patients. Anesth Analg. 2001; 92:1126-30.
- Min JK, Spencer KT, Furlong KT, et al. Clinical features of complications from transesophageal echocardiography: a single-center case series of 10,000 consecutive examinations. J Am Soc Echocardiogr. 2005; 18:925-9.
- Muralidhar K, Kapoor PM, et al. Perioperative transesophageal echocardiography guidelines. Ann Card Anaesth. 2013; 16:321-9.
- Flachskampf FA, Daniel WG. Transesophageal echocardiography: state of the art. Ann Intern Med. 1991; 115:425-33.
- American Society of Anesthesiologists, Society of Cardiovascular Anesthesiologists. Practice guidelines for perioperative transesophageal echocardiography. Anesthesiology. 2010; 112:1084-96.
- Swaminathan M, Nicoara A, Phillips-Bute B, et al. Utility of intraoperative transesophageal echocardiography in valve surgery. J Thorac Cardiovasc Surg. 2013; 145:1030-7.
- Shanewise JS, Cheung AT, Aronson S, et al. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination. Anesth Analg. 1999; 89:870-84.
- Sidebotham D, Allen SJ, McGeorge AD, et al. Safety and feasibility of transesophageal echocardiography in the intensive care unit: a prospective study of 2000 examinations. Intensive Care Med. 1998; 24:683-9.
10. Fleming RM, Boyd D, Forster J, et al. Complications of TEE in anticoagulated patients. Echocardiography. 2001; 18:539-42
Background
Transesophageal echocardiography (TEE) has become an indispensable diagnostic and monitoring tool in cardiac surgery,
yet its semi-invasive nature is associated with complications and limitations. Understanding these risks is crucial for safe clinical
practice.
Objective
To review the potential complications, contraindications, limitations, and pitfalls of TEE in cardiac surgery and to provide
a balanced appraisal of its utility in perioperative management.
Methods
Literature-based review of complications, contraindications, and limitations related to TEE, supported by evidence from
large case series and guideline documents. Clinical data were synthesized from key published studies and institutional
experiences.
Results
Major complications of TEE are rare, ranging from 0.2% to 0.5% in diagnostic settings, with mortality below 0.01%.
Intraoperative use increases complication risk (0.2–1.2%), including esophageal trauma, arrhythmias, airway obstruction, and
hemodynamic compromise. Pediatric patients present additional risks due to anatomical constraints. Contraindications include
esophageal pathologies and recent upper GI surgery. Limitations include restricted visualization of certain cardiac structures
and artifacts that may mimic pathology.
Conclusion
Despite its risks, TEE remains an essential perioperative tool in cardiac surgery. Awareness of its complications and
limitations allows clinicians to optimize patient safety while benefiting from its diagnostic power.
Keywords :
Transesophageal Echocardiography, Cardiac Surgery, Complications, Limitations, Perioperative Monitoring.