• Nika Samadzadeh Tabrizi, Isha Doshi, Alexander D Shapeton, Perry A Stout, Stephanie B Jones, Mohammad El-Hajjar, Mikhail Torosoff, and Sridhar R Musuku.
• Albany Medical College, Albany, NY. Electronic address: samadzn@amc.edu.
• J. Cardiothorac. Vasc. Anesth. 2023 Oct 1; 37 (10): 192219281922-1928.

ObjectivesTransesophageal echocardiography-related complications (TEE-RC) are higher in structural heart interventions than in traditional operative settings. In mitral valve transcatheter edge-to-edge repair (MV-TEER), the incidence of TEE-RC may be higher than in other structural interventions. However, existing reports are limited and robust data evaluating TEE safety in this patient population are lacking. The authors sought to describe the incidence and risk factors of upper gastrointestinal injuries after TEE in patients undergoing MV-TEER.DesignA retrospective observational study.SettingA single tertiary academic hospital.ParticipantsA total of 442 consecutive patients who underwent MV-TEER, specifically with MitraClip, between December 2015 and March 2022.InterventionsTransesophageal echocardiography was performed intraoperatively to guide all MV-TEERs.Measurements And Main ResultsThe study's primary goal was to investigate an association between TEE procedure duration and TEE-RC risk. The contribution of demographic risk factors and intraprocedural characteristics also was investigated. Transesophageal echocardiography-RCs were observed in 17 out of 442 patients (3.8%). Dysphagia was the most common TEE-RC (n = 9/17, 53%), followed by new gastroesophageal reflux (n = 6/17, 35%) and odynophagia (n = 3/17, 18%). There were no esophageal perforations or upper gastrointestinal bleeds. History of dysphagia was the only variable associated with TEE-RCs (p = 0.008; n = 9 [2.1%] v n = 3 [18%]), with a relative risk of 8.67 (95% CI 2.57, 29.16). The TEE procedure duration was not statistically different between the 2 groups (46 minutes [39-64] in TEE-RCs v 49 minutes [36-77] in no complications).ConclusionIn patients undergoing MV-TEER, TEE-RCs are uncommon, and major complications are rare. The authors' outcomes reflect those of a high-volume referral center with TEEs performed by cardiac anesthesiologists.Copyright © 2023 Elsevier Inc. All rights reserved.

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