Saba Altarawneh, MD1, Abdelwahap Elghezewi, MD1, Hafiz Zarsham Ali Ikram, MD2, Amro Altarawneh, MD3, Kamran Zaheer, DO1 1Marshall University, Huntington, WV; 2Marshall University School of Medicine, Huntington, WV; 3The Hashimite University, Huntington, WV
Introduction: Gastroenterologists get consulted to perform esophagogastroduodenoscopy EGD before transesophageal echocardiography TEE in patients with a history of gastrointestinal GI bleeding, varices, and other GI pathologies, although the bleeding incidence with TEE is < 0.01% and there is no published data on the utility of EGD before TEE we still see this in practice. Our retrospective study aims to study the significance of getting EGD before TEE at our facility in decreasing the incidence of GI bleeding associated with TEE.
Methods: Data was collected manually from our electronic medical records after IRB approval was obtained. We collected data from 2018-2023 for patients above 17 years old who underwent TEE procedures in that period, variables include age, gender, hemoglobin level, EGD procedure before or after the TEE, anticoagulation therapy, anti-platelets therapy, and previous GI bleeding.
Results: A total of 112 patients were studied, 55 were females with a percentage of 49.11%, with a Median age of 52, 43 patients 38.39% were on oral anticoagulation, 33.93% were on anti-platelets therapy, 3.57% had a history of GI bleed. We found that 20.54% had a hemoglobin drop >1 g/dl 10 days after TEE, and 0.04% of these patients who had hemoglobin drop was related to GI bleeding. Of the total study population 0.89% had GI bleeding after the TEE in 30 days period. 1.79% underwent EGD after the TEE in 30 days period.
Discussion: Although TEE considers a safe procedure there are still relative contraindications related to GI pathologies including but not limited to esophageal varices and strictures. However, published literature on the significance of getting EGD before TEE is limited. Furthermore, EGD is an invasive procedure associated with increased risk of complication, the health care cost, and burden on gastroenterology service with no significant change in adverse outcomes after TEE as shown by our retrospective study which goes along with the published data so far.
Disclosures:
Saba Altarawneh indicated no relevant financial relationships.
Abdelwahap Elghezewi indicated no relevant financial relationships.
Hafiz Zarsham Ali Ikram indicated no relevant financial relationships.
Amro Altarawneh indicated no relevant financial relationships.
Kamran Zaheer indicated no relevant financial relationships.
Saba Altarawneh, MD1, Abdelwahap Elghezewi, MD1, Hafiz Zarsham Ali Ikram, MD2, Amro Altarawneh, MD3, Kamran Zaheer, DO1. P0602 - Does EGD Prior to TEE Change the Incidence of Adverse Outcomes?, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
