Complications Associated With Transesophageal Echocardiography in Transcatheter Structural Cardiac Interventions

Area of Science:

• Cardiology
• Medical Imaging
• Interventional Cardiology

Background:

• Transesophageal echocardiograms (TEEs) are increasingly used in transcatheter structural cardiac interventions.
• Data on TEE-related complications in this setting are limited.
• Complications may be higher than in nonoperative or surgical contexts.

Purpose of the Study:

• To evaluate the prevalence of major complications associated with TEE during transcatheter structural cardiac interventions in the United States.
• To identify patient factors associated with increased complication risk.

Main Methods:

• Retrospective cohort study using the TriNetX Research Network electronic health record database (2012-2022).
• Identified patients undergoing TEE for various transcatheter structural interventions.
• Defined primary outcome as major complications (bleeding, esophageal/respiratory injury) within 72 hours.

Main Results:

• 3.6% of 12,043 patients experienced major complications.
• Higher complication rates in patients on anticoagulation/antiplatelet therapy (3.9% vs 0.5%) and those aged ≥65 (3.9% vs 2.2%).
• 2.5% major complication rate observed in 28,848 patients undergoing TEE-guided surgical valve replacement.

Conclusions:

• Over 3% of patients undergoing TEE for transcatheter structural interventions experience major complications.
• Elderly patients and those on antithrombotic therapy face higher risks.
• Enhanced risk assessment and practice updates are needed for TEE-guided procedures.