Safety of transesophageal echocardiography during transcatheter edge-to-edge tricuspid valve repair: A single-center experience

Katharina Hellhammer; Robert Schueler; Mareike Eißmann; Brigitte Schumacher; Alexander Wolf; Oliver Bruder; Thomas Schmitz; Moritz Lambers

doi:10.3389/fcvm.2022.856028

Safety of transesophageal echocardiography during transcatheter edge-to-edge tricuspid valve repair: A single-center experience

Front Cardiovasc Med. 2022 Oct 11:9:856028. doi: 10.3389/fcvm.2022.856028. eCollection 2022.

Authors

Katharina Hellhammer¹, Robert Schueler¹, Mareike Eißmann¹, Brigitte Schumacher^{2

3}, Alexander Wolf¹, Oliver Bruder^{1

4}, Thomas Schmitz¹, Moritz Lambers¹

Affiliations

¹ Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth Hospital Essen, Essen, Germany.
² Department of Internal Medicine and Gastroenterology, Elisabeth Hospital Essen, Essen, Germany.
³ Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
⁴ Faculty of Medicine, Ruhr University Bochum, Bochum, Germany.

Abstract

Objectives: We aimed to determine transesophageal echocardiography (TEE) related complications during Transcatheter edge-to-edge tricuspid valve repair (TTVR).

Background: Transesophageal echocardiography is essential to guide structural heart disease (SHD) interventions. TTVR has become an evolving procedure for high-risk patients not suitable for surgery. Whether this complex procedure is associated with TEE related complications is not known so far.

Methods: We retrospectively analyzed 64 consecutive patients undergoing TTVR between 2019 and 2021 with the TriClip system (Abbott, Chicago, IL, USA) at our center. All procedures were performed under general anesthesia (GA). TEE related complications were classified as major and minor complications.

Results: Transesophageal echocardiography related complications were observed in two patients (3.1%) with one major complication (1.6%) and one minor complication (1.6%). In one patient perforation of the esophageal mucosa requiring red blood cell transfusion was observed, the other patient had hematemesis due to minor esophageal and gastric lesions without the need for blood transfusion. Both patients recovered during hospital stay with no persistent symptoms at discharge.

Conclusions: Transesophageal echocardiography related complications during TTVR are clinically relevant occurring in 3.1% of the patients. Further investigations are needed to identify potential risk factors and patients at high risk to develop a TEE related complication in the course of TTVR.

Keywords: complications; interventional imaging; safety; transcatheter tricuspid valve repair; transesophageal echocardiography.