Does an Upper Endoscopy Before Transesophageal Echocardiography Change Patient Management?
J Clin Gastroenterol. 2015 Apr 27;
Authors: Zuchelli T, Alsheik E, Chu C, Bhandari B
Abstract
GOAL: To determine if esophagogastroduodenoscopy (EGD) before transesophageal echocardiography (TEE) will change patient management.
BACKGROUND: Before TEE gastroenterologists are often consulted to evaluate patients with a history of dysphagia, known gastrointestinal (GI) disease, or GI bleed. There are no known published data on the clinical utility of EGD before TEE.
DESIGN AND SETTING: Retrospective study at an inner city tertiary-care center.
PATIENTS: A total of 134 patients were included who were at least 18 years old and underwent an EGD to evaluate the safety of the blind passage of a TEE probe.
RESULTS: In total, 134 patients were identified. Twenty patients (15%) were not cleared for TEE due to esophageal surface abnormalities (n=3; esophagitis, ulcer, mucosal tear), esophageal structural abnormalities (n=10; varices, stricture, ring, web, hernia, Zenker), and combinations thereof (n=7). Of the 20 patients not cleared for TEE, 17 never underwent a TEE and 3 patients underwent a TEE 7 to 180 days later. Two patients undergoing EGD and 5 patients undergoing TEE experienced adverse cardiopulmonary events.
CONCLUSIONS: Our results demonstrate that an EGD before TEE can elucidate findings that may preclude the passage of a blind probe in patients with upper GI symptoms or known esophageal disease. Therefore, we propose that an EGD is clinically beneficial before TEE and can change patient management.
PMID: 25930975 [PubMed - as supplied by publisher]