Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2954
Peer-review started: November 9, 2021
First decision: December 27, 2021
Revised: January 5, 2022
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: March 26, 2022
Processing time: 132 Days and 21.7 Hours
In recent years, it has been recognized that transesophageal echocardiography (TEE) is of great value in resuscitation of cardiac arrest. However, its safety has rarely been reported.
We present a 59-year-old male patient scheduled to undergo cardiac surgery for rheumatic heart disease. Upper gastrointestinal bleeding from a Mallory-Weiss tear appeared following cardiopulmonary resuscitation, TEE, and percutaneous cardiopulmonary bypass resuscitation when he suffered from aesthesia-related cardiac arrest. Gastrointestinal injury was diagnosed promptly and treated effectively. However, the exact etiology of gastrointestinal injury was unclear; the interaction of closed-chest cardiac massage and the application of TEE may be involved as a most possible mechanism of injury.
Serious complications should be considered when TEE is used in patients with special pathophysiological conditions.
Core Tip: In recent years, transesophageal echocardiography (TEE) has been recognized as a valuable imaging tool to provide diagnostic and prognostic information for both cardiopulmonary resuscitation (CPR) cases and non-CPR cases. Although it is generally considered safe, some serious complications, including esophageal perforation and mucosal damage, have been observed in non-CPR cases. To our knowledge, there is no literature on the safety of TEE during CPR. We here report the first case of upper gastrointestinal bleeding from a Mallory-Weiss tear associated with TEE during successful CPR and percutaneous cardiopulmonary bypass resuscitation.