Abstract
BackgroundThe transesophageal echocardiograhpy (TEE) has been studied worldwide. However, identifying additional factors on top of operator's experience and patient's cooperation which could influence the success of the procedure in unsedated patients with heart disease is not well documented.MethodsUnder the cross-sectional descriptive design, 85 target patients were fulfilling the criteria: being Thai national at the age of at least 20-year-old, being performed TEE by the study participant’s cardiologists, being able to communicate verbally. Seven outcomes were recorded, including gag reflex, insertion attempt, insertion time, vital signs (heart rate, oxygen saturation and mean arterial blood pressure), visible blood on TEE probe tip, and oropharyngeal pain at 1 h and 24-h.ResultsThere were 85 eligible patients during June 2012 to June 2013. The major participants were male (46, 54 %) and the mean age was 51.2 ± 12.5 years. The MMC class III was mostly found (33, 38.80 %). TEE probe insertion time and gag reflex were indicated statistical significance (P < 0.05). Linear regression revealed that MMC class III (b 3.718; SD ± 1.077; P = 0.001) and class IV (b 5.15; SD ± 1.286; P = 0.000) were statistically associated with TEE probe insertion time, whereas MMC class II was no statistically significant (b 2.348; SD ± 1.405; P = 0.099) according to constant value in MMC class I (5.318 s). Similarly, logistic regression indicated that the patients with high grade MMC were more likely to have gagging than the low grade MMC patients (MMC 2 OR 0.567, 95 % CI 0.09–3.42, P = 0.536; MMC 3 OR 5.231, 95 % CI 1.55–17.67, P = 0.008; MMC 4 OR 3.4, 95 % CI 0.84–13.76, P = 0.086).ConclusionsModified Mallampati Classification is one of determining factors in the success of unsedated TEE procedure in patients with heart disease, especially for assessment of gagging and successful TEE probe insertion time.
Highlights
The transesophageal echocardiograhpy (TEE) has been studied worldwide
In the field of gastrointestology, Huang, et al compare the tolerance in esophagogastroduodenoscopy (EGD) among the patients based on Modified Mallampati Classification (MMC) [6]
The result clearly shows that the patients with MMC class III and class IV mostly present gagging during the procedure which leads the patient to be intolerant and be given sedation
Summary
Identifying additional factors on top of operator's experience and patient's cooperation which could influence the success of the procedure in unsedated patients with heart disease is not well documented. Even though TEE probe insertion is technically easier than endotracheal tube intubation, some complications can occur since the long probe has to be passed oropharynx before being inserted into the esophagus. From this point of view, our present study aims to identify additional factors on top of operator experience and patient co-operation which can influence the success of a TEE procedure in unsedated patients with heart disease
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