Clinical Utility of Transoesophageal Echocardiogram at Cardiac Center-Sana’a city, Yemen

Abstract

Background: Transesophageal echocardiography is not only an invaluable diagnostic tool for cardiac patients, but also is essential for cardiac monitoring in critically ill patients in cardiac and noncardiac surgery settings and in the differential diagnosis of unexplained hemodynamic collapse. Aim: To assess the first detailed review of the indications and clinical utility of TEE in noninvasive diagnostic cardiac unit at cardiac center in TMGH-Sana’a city, Yemen. Methods: A hospital based study was done among patients who had TEE performed at the cardiac center, TMGH from 1-Jun to 31-December 2009 and from 1-Jun to 31-December 2011. Data for 856 patients were abstracted and reviewed. Information gathered included demographic data, indications for the procedure, findings and clinical recommendations. Data were collected from all reports of performed TEE for presented patients and the used machine was hp 5500 echo. Results: Most of the patients was RHD which represents around 88% and female represent nearly 65%. The most common condition in 2009, 51.5% of the cases were diagnosed RHD, 4.3% CHD and 1.3% PH while in 2011, 36.4% were diagnosed RHD, 2.9% CHD and 0.7% PH. Cardiac surgery in 26% in 2009 & 30% in 2011 or for balloon mitral valvuloplasty 53% in 2009 & 33.6% in 2011.The most common complications were thrombus in left atrium & left atrial appendage& vegetation formation, thrombus takes 4% 14% in 2009 & 2001 respectively, Vegetation was found to be on mitral (3.5%& 2.8%) 2009, 2011 aortic (0.8% & 2.3%) or on both valves (1%) in 2009 % 2011. Cardiac surgery 25.9% in 2009 and 30.2% in 2011 or balloon mitral valvuloplasty 53% in 2009 and 33.6% in 2011 were recommended to management of patients while 10.2% in 2009 and 16.4% in 2011 were recommended to receive oral anticoagulant therapy for 8 weeks. Conclusion: TEE has been commonly performed to evaluate heart disease in Yemen without any major complications resulting from the procedure.