Risk of dysphagia after transesophageal echocardiography during cardiac operations

Fatores relacionados à disfagia orofaríngea no pós-operatório de cirurgia cardíaca: revisão sistemática

“…Only studies published in English conducted in the United States (60%) (9,10,17) and Canada (40%) (11,18) were included in this literature review. The study sample ranged from 254 (18) to 1042 (10) individuals (mean 781.2).…”

“…Impairment of the swallowing function may be present in various conditions in hospitalized patients, such as in the cases of trauma, stroke, and chronic obstructive pulmonary disease, as well as in patients with cardiopathies (8) . In this context, in recent years, research has indicated a possible relationship between cardiac surgery and the development of oropharyngeal dysphagia in the postoperative period due to exposure of patients to various risk factors, such as endotracheal intubation (OTI), cardiopulmonary bypass (CPB), transesophageal echocardiography (TEE), among others (8)(9)(10)(11) . A study conducted with 361 patients undergoing CABG showed an incidence of 53.5% of respiratory infection postoperatively (12) , indicating the need to evaluate the presence of oropharyngeal dysphagia in this population, especially in individuals at risk for aspiration (13) .…”

Transesophageal echocardiography-related complications

“…76 The mechanisms of such dysphagia may include local compression from the insertion maneuver or from the extent of probe insertion, both of which could affect the pharyngoesophageal tissue and/or the laryngeal nerve. Laryngeal nerve palsy occurs more commonly in female patients 77,78 because of a narrower laryngeal anatomy in females than in males.…”

“…77 Adult patients undergoing TEE display a 7.8-fold increase in postoperative dysphagia. 76 Dynamic swallowing studies have proven that four percent of adult patients exhibit mechanical swallowing dysfunction presenting as cough and dysphagia upon extubation after cardiac surgery. 79 Using barium cineradiography, dysphagia was observed in 7.9% of 126 patients undergoing intraoperative TEE during cardiac surgery vs 1.8% of 712 patients who did not undergo TEE.…”

“…79 Using barium cineradiography, dysphagia was observed in 7.9% of 126 patients undergoing intraoperative TEE during cardiac surgery vs 1.8% of 712 patients who did not undergo TEE. 76 Dysphagia was associated with pulmonary aspiration in 90% of cases, resulting in greater incidence of tracheotomies and a longer hospital stay. Associated risk factors include advanced age (P < 0.001), length of postoperative intubation (P < 0.001), and perioperative TEE examination (P < 0.003).…”