Esophageal Overtube Facilitation of Transesophageal Echocardiography in Patients with Previously Difficult Esophageal Intubation

• Published in: Journal of the American Society of Echocardiography Vol. 20; no. 3; pp. 285 - 289
• Main Authors: Reuss, Christina S., MD, Triester, Stuart L., MD, Lynch, John J., MD, Heigh, Russell I., MD, Fleischer, David E., MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-03-2007
• Subjects: Aged; Aged, 80 and over; Cardiovascular; Echocardiography, Transesophageal - instrumentation; Echocardiography, Transesophageal - methods; Endosonography - instrumentation; Endosonography - methods; Female; Humans; Image Enhancement - instrumentation; Image Enhancement - methods; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - methods; Male
• ISSN: 0894-7317; 1097-6795
• DOI: 10.1016/j.echo.2006.08.012

Background In upper endoscopy, overtubes protect the hypopharynx and esophagus in patients requiring multiple esophageal intubations. Transesophageal echocardiography (TEE) is frequently used in general cardiology practice to provide high-resolution, real-time images of cardiac structures that are often not visualized by transthoracic imaging alone. Patients with a history of esophageal disorders or difficult esophageal intubations may have increased risk for complications from the echoprobe. An esophageal overtube may facilitate TEE in such patients. Objective We sought to evaluate the usefulness of upper endoscopy with placement of an esophageal overtube to facilitate TEE in patients with prior difficult esophageal intubations. Methods We performed upper endoscopy, followed by placement of an esophageal overtube, in 4 patients who had an unsuccessful intubation with the TEE probe. The endoscopic procedures were successfully completed, thus, allowing for uneventful subsequent TEE. Conclusions Upper endoscopy with placement of an esophageal overtube may allow for safe successful completion of TEE in patients with previously unsuccessful blind esophageal intubation.