Incidence and Risk Factors For Esophageal Perforation During Transesophageal Echocardiography: A Decade of Evidence From an International Federated Database

Document Type

Conference Proceeding

Publication Date

4-7-2026

Publication Title

Journal of the American College of Cardiology

Abstract

BACKGROUND Esophageal perforation (ESP) is a rare but serious complication of transesophageal echocardiography (TEE). We aimed to determine the incidence and temporal trend of ESP in TEE procedures and identify the associated key factors independently associated with ESP. METHODS This retrospective cohort study utilized the TriNetX network to identify adult patients who underwent TEE between Jan 1, 2016, and Dec 31, 2023. Patients were stratified based on ESP occurrence with propensity score matching. Multivariable Cox regression analysis was used to identify the independent predictors of ESP in TEE patients with adjusted hazard ratios (HR). RESULTS Among the 598,775 patients who underwent TEE, 291 (0.05%) developed ESP. In a multivariable analysis, significant predictors of ESP included tobacco use (HR1.20), alcohol use (HR1.81), esophagitis (HR4.98), esophageal motor disorders (HR6.94), protein-calorie malnutrition (HR5.43), chronic kidney disease (HR1.81), liver cirrhosis (HR1.24), and systemic sclerosis (HR4.31). CONCLUSION Advanced age, tobacco use, alcohol use, esophageal pathology, malnutrition, and chronic systemic illnesses are associated with higher risk of ESP after TEE.

Volume

87

Issue

13 Suppl

First Page

A909

Comments

American College of Cardiology 75th Annual Scientific Session & Expo, March 28-30, 2026, New Orleans, LA

Last Page

A910

DOI

10.1016/j.jacc.2026.02.2243

Link to Full Text

Share

COinS