Review of Complications in a Series of Patients With Known Gastro-Esophageal Varices Undergoing Transesophageal Echocardiography

Background: The presence of gastroesophageal varices is considered a relative contraindication to performing transesophageal echocardiography (TEE), but this is based on expert opinion, and there is limited data to support this recommendation. The aim of this study was to review the complications and benefit of performing TEE in patients with known gastroesophageal varices. Methods: Fourteen patients with known esophageal varices who underwent TEE from 1997 to 2007 were identified. Patients' charts were reviewed for procedure-related complications as well as benefit in performing TEE. Results: The 14 patients had an average age of 50.4 years. Six patients had grade 2 esophageal varices at the time of TEE. The most common etiology of portal hypertension was alcoholic liver disease (11 of 14), and the most common indication for TEE was to rule out endocarditis (11 of 14). There were no major bleeding or other complications noted. All 14 procedures were able to provide the clinical information requested. Conclusion: Although the presence of known esophageal varices was previously thought to be a contraindication to performing TEE, the results of this study show that TEE without transgastric views can be performed without serious complications in patients with grade 1 or 2 esophageal varices who have not experienced recent variceal hemorrhages. Additionally, there is a definite benefit, as all of the clinical questions were successfully answered. (J Am Soc Echocardiogr 2009;22:396-400.)