PMID- 34977935 OWN - NLM STAT- MEDLINE DCOM- 20221221 LR - 20221223 IS - 2047-2412 (Electronic) IS - 2047-2404 (Linking) VI - 24 IP - 1 DP - 2022 Dec 19 TI - Safety of transoesophageal echocardiography during structural heart disease interventions under procedural sedation: a single-centre study. PG - 68-77 LID - 10.1093/ehjci/jeab280 [doi] AB - AIMS: The aim of this study was to determine the incidence of transoesophageal echocardiography (TOE)-related adverse events (AEs) during structural heart disease (SHD) interventions and to identify potential risk factors. METHODS AND RESULTS: We retrospectively analysed 898 consecutive patients undergoing TOE-guided SHD interventions under procedural sedation. TOE-related AEs were classified as bleeding complications, mechanical lesions, conversion to general anaesthesia with intubation, and the occurrence of pneumonia. A follow-up was conducted up to 3 months after the intervention. TOE-related AEs were observed in 5.3% of the patients (n = 48). The highest rate of AEs was observed in the percutaneous mitral valve repair (PMVR) group with 8.2% (n = 32), whereas 4.8% (n = 11) of the patients in the left atrial appendage group and 1.8% (n = 5) in the patent foramen ovale/atrial septal defect group developed a TOE-related AE (P = 0.001). The most frequent AE was pneumonia with an incidence of 2.6% (n = 26) in the total cohort. Bleeding events occurred in 1.8% (n = 16) of the patients, mostly in the PMVR group with 2.1% (n = 8). In the multivariate regression analysis, we found a lower haemoglobin odds ratio (OR) [95% confidence interval (CI)]: 8.82 (0.68-0.98) P = 0.025 and an obstructive sleep apnoea syndrome (OSAS) [OR (95% CI): 2.51 (1.08-5.84) P = 0.033] to be associated with AE. Furthermore, AEs were related to procedural time [OR (95% CI): 1.01 (1.0-1.01) P = 0.056] and oral anticoagulation [OR (95% CI): 1.97 (0.9-4.3) P = 0.076] with borderline significance in the multivariate regression analysis. No persistent damages were observed. CONCLUSION: TOE-related AEs during SHD interventions are clinically relevant. It was highest in patients undergoing PMVR. A lower baseline haemoglobin level and an OSAS were found to be associated with the occurrence of a TOE-related AE. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2022. For permissions, please email: journals.permissions@oup.com. FAU - Afzal, Shazia AU - Afzal S AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Zeus, Tobias AU - Zeus T AUID- ORCID: 0000-0002-4517-0068 AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Hofsahs, Timo AU - Hofsahs T AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Kuballa, Matti AU - Kuballa M AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Veulemans, Verena AU - Veulemans V AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Piayda, Kerstin AU - Piayda K AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Heidari, Houtan AU - Heidari H AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Polzin, Amin AU - Polzin A AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Horn, Patrick AU - Horn P AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Westenfeld, Ralf AU - Westenfeld R AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Kelm, Malte AU - Kelm M AUID- ORCID: 0000-0003-0060-1052 AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. AD - CARID (Cardiovascular Research Institute Dusseldorf), Heinrich Heine University Dusseldorf, 40225 Dusseldorf, Germany. FAU - Hellhammer, Katharina AU - Hellhammer K AUID- ORCID: 0000-0003-1287-4605 AD - Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Dusseldorf, Medical Faculty, Moorenstrasse 5, 40225 Dusseldorf, Germany. LA - eng PT - Journal Article PL - England TA - Eur Heart J Cardiovasc Imaging JT - European heart journal. Cardiovascular Imaging JID - 101573788 SB - IM MH - Humans MH - Echocardiography, Transesophageal MH - Retrospective Studies MH - *Heart Diseases MH - *Foramen Ovale, Patent MH - *Cardiac Surgical Procedures OTO - NOTNLM OT - safety OT - structural heart disease interventions OT - transoesophageal echocardiography COIS- Conflict of interest: none declared. EDAT- 2022/01/04 06:00 MHDA- 2022/12/22 06:00 CRDT- 2022/01/03 05:58 PHST- 2021/11/02 00:00 [received] PHST- 2021/12/14 00:00 [accepted] PHST- 2022/01/04 06:00 [pubmed] PHST- 2022/12/22 06:00 [medline] PHST- 2022/01/03 05:58 [entrez] AID - 6491865 [pii] AID - 10.1093/ehjci/jeab280 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Imaging. 2022 Dec 19;24(1):68-77. doi: 10.1093/ehjci/jeab280.