Non-invasive ventilation-aided transoesophageal echocardiography in high-risk patients: a pilot study

Eur J Echocardiogr. 2010 Jul;11(6):554-6. doi: 10.1093/ejechocard/jeq019. Epub 2010 Feb 25.


Aims: Transoesophageal echocardiography (TEE) may require patient sedation, eventually leading to respiratory depression, a risky condition in severe cardiac disease. Non-invasive ventilation (NIV) has been applied during diagnostic manoeuvres, but its use during TEE has not been reported. We describe NIV-aided continuous TEE monitoring under sedation in the supine position in three consecutive orthopnoeic patients with severe aortic valve stenosis: two of them underwent percutaneous aortic valve implantation, and one underwent aortic valvuloplasty.

Methods and results: The TEE probe was passed through a hole performed with a surgical cutter in an NIV face-mask. Pulsoximetry, heart rate, arterial blood pressure, respiratory rate, arterial blood gases, patients' comfort, and patient's sedation were monitored throughout the procedure. Percutaneous aortic valve implantation procedures lasted almost 2 h, while the valvuloplasty procedure lasted 70 min. Non-invasive ventilation and continuous TEE were performed throughout the procedures without technical problems or respiratory or haemodynamic complications, and all patients felt always comfortable.

Conclusion: Non-invasive ventilation through a modified face-mask allowed to perform continuous TEE examination and to avoid tracheal intubation and general anaesthesia in three high-risk patients undergoing beating heart treatment of aortic valve stenosis.

MeSH terms

  • Aged, 80 and over
  • Anesthesia, General / adverse effects*
  • Angioplasty, Balloon, Coronary*
  • Aortic Valve*
  • Catheterization / instrumentation
  • Catheterization / methods
  • Echocardiography, Transesophageal / instrumentation*
  • Echocardiography, Transesophageal / methods
  • Female
  • Heart Rate
  • Heart Valve Prosthesis Implantation / instrumentation
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Laryngeal Masks / adverse effects
  • Male
  • Oximetry
  • Pilot Projects
  • Respiration, Artificial / instrumentation
  • Respiration, Artificial / methods*
  • Risk Assessment