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Does an Upper Endoscopy Before Transesophageal Echocardiography Change Patient Management?
Journal article   Peer reviewed

Does an Upper Endoscopy Before Transesophageal Echocardiography Change Patient Management?

Tobias Zuchelli, Eva Alsheik, Christopher Chu, Bhavik Bhandari and Christine Anne Chu
Journal of clinical gastroenterology, v 49(10), pp 848-852
Nov 2015
DOI: https://doi.org/10.1097/MCG.0000000000000332
PMID: 25930975
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Adult Aged Aged, 80 and over Deglutition Disorders - etiology Echocardiography, Transesophageal - methods Endoscopy, Digestive System - methods Esophageal Diseases - diagnostic imaging Esophageal Diseases - etiology Esophageal Diseases - surgery Esophagus - diagnostic imaging Esophagus - pathology Esophagus - surgery Female Gastrointestinal Diseases - etiology Gastrointestinal Hemorrhage - etiology Humans Male Middle Aged Preoperative Care - methods Retrospective Studies Young Adult
To determine if esophagogastroduodenoscopy (EGD) before transesophageal echocardiography (TEE) will change patient management. 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. Retrospective study at an inner city tertiary-care center. 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. 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. 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.

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12 citations in Web of Science
14 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Gastroenterology & Hepatology
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