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British Journal of Anaesthesia, 2002, Vol. 88, No. 4 592-594
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Oesophagotracheal perforation after intraoperative transoesphageal echocardiography in cardiac surgery

J.-B. Lecharny*,1, I. Philip1 and J.-P. Depoix1

1Service d’Anesthésiologie et Réanimation Chirurgicale, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, F-75018 Paris, France*Corresponding author

Although transoesophageal echocardiography (TOE) can be considered a safe procedure, severe complications may occur. We report an oesophagotracheal perforation diagnosed 7 days after a complex and very long four-valve replacement procedure in a patient with a poor preoperative condition. We believe that an ischaemic lesion of the oesophagotracheal wall caused by the TOE probe was the initial event leading to this perforation. This observation raises concerns about the safety of prolonged TOE monitoring and suggests that a combination of risk factors (i.e. a small stature, a very long procedure, congestive heart failure, and a low cardiac output before and after cardiopulmonary bypass) may warrant increased precautions while performing TOE during cardiac surgery.

Br J Anaesth 2002; 88: 592–4


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