Safety of transesophageal echocardiography (TEE)-A 10 year experience at a tertiary care cardiac institute.

Objective: To assess the safety profile, major and minor complications, and risk mitigation strategies associated with TEE. Study Design: Retrospective observational study. Setting: Rehmat-ul-lil-Alameen postgraduate institute of Cardiology (RAIC), PESSI, Lahore. Period: Ten-year data focusing on TEE procedures (September 2014 to March 2025) was utilized. Methods: A total of 358 procedures were studied, carried out by 02 consultant cardiologists. In addition to demographic data, variables including indications and complications of TEE were studied. Statistical analysis was performed using SPSS Version 22. Results: TEE is proved to be generally safe, with major complications occurring in 0.2% of cases. There was no procedure related mortality. Minor complications, such as odynophagia, throat discomfort and minor pharyngeal bleed, were also uncommon (5.02%). The most common indication of diagnostic TEE was assessment of atrial septal defect 102(31.0%) while in case of intraoperative TEE, the most common indication was minimally invasive cardiac surgery 20(66.0%). The most common TEE complication (minor) was odynophagia that occurred in 1.3% of the population. Conclusion: While TEE has an excellent safety profile, clinicians must remain vigilant to prevent and promptly manage complications. Proper patient selection, adherence to guidelines, and operator expertise are crucial for ensuring patient safety. Future advancements in probe design and sedation protocols may further reduce risks.