Gastroenterologische Kontraindikationen der Transösophagealen Echokardiographie

Gastroenterological contraindications to transoesophageal echocardiography. Transoesophageal echocardiography (TEE) is considered a safe procedure. Serious or even fatal complications are rare. The most relevant gastrointestinal complication is oesophageal perforation. The reported incidence is ≤0.3% for intraoperative TEE, and <0.01% in the ambulatory setting. A number of gastrointestinal conditions may predispose to complications. Thus TEE guidelines have defined several absolute and relative contraindications. Whereas an absolute contraindication indicates a prohibitive risk, the presence of relative contraindications allows for an individual risk-benefit analysis that is best undertaken in collaboration with a gastroenterologist. This tutorial article comments on some of the gastroenterological diagnoses involved, in order to encourage the cardiologist to screen each patient’s file and question the patient for oesophageal symptoms (namely dysphagia and odynophagia) prior to TEE. Compliance with guidelines does not, however, completely rule out a residual risk for serious complications.