Esophageal-Pleural Fistula after Intraoperative Transoesophageal Echocardiography in A Patient with Enlarged Left Atrium

1
Mario Torre
Mario Torre
3
MSc
MSc
4
Maria Giovanna Vassallo
Maria Giovanna Vassallo
5
Maria Grazia Romeo MD
Maria Grazia Romeo MD
6
Alberto Bonadies
Alberto Bonadies
7
Antonio Longobardi
Antonio Longobardi
8
Francesco Pirozzi
Francesco Pirozzi
9
Pompea Bottiglieri
Pompea Bottiglieri
10
Annarita Iavazzo
Annarita Iavazzo
11
Leonardo De Luca
Leonardo De Luca
12
Enrico Coscioni
Enrico Coscioni

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After mitral valve replacement in an 81-year-old woman, there was evidence of an important communication between the esophagus and the right pleura. Diagnosis was confirmed with Oral Gastrografin radiography and esophagoscopy. Thoracic computed tomography scans better indicated fistula location and extension, but also showed the close relationship and the compression of huge left atrium on the oesophagus. Our hypothesis was that the lesion was induced by transoesophageal echocardiography probe in a favourable setting. An enlarged left atrium should be recognized as a risk factor for TEE-induced esophageal perforation, especially in fragile patients, with marked esophagus distortion.

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No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

Ethical Approval

No ethics committee approval was required for this article type.

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Not applicable for this article.

Mario Torre. 2026. \u201cEsophageal-Pleural Fistula after Intraoperative Transoesophageal Echocardiography in A Patient with Enlarged Left Atrium\u201d. Unknown Journal GJMR-I Volume 22 (GJMR Volume 22 Issue I3): .

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Detailed analysis of esophageal function and diagnostics in patients with large atrium. Focus on transesophageal echocardiography.
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GJMR-I Classification: DDC Code: 617.4120597 LCC Code: RD598
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January 5, 2023

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After mitral valve replacement in an 81-year-old woman, there was evidence of an important communication between the esophagus and the right pleura. Diagnosis was confirmed with Oral Gastrografin radiography and esophagoscopy. Thoracic computed tomography scans better indicated fistula location and extension, but also showed the close relationship and the compression of huge left atrium on the oesophagus. Our hypothesis was that the lesion was induced by transoesophageal echocardiography probe in a favourable setting. An enlarged left atrium should be recognized as a risk factor for TEE-induced esophageal perforation, especially in fragile patients, with marked esophagus distortion.

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Esophageal-Pleural Fistula after Intraoperative Transoesophageal Echocardiography in A Patient with Enlarged Left Atrium

Mario Torre
Mario Torre
MD
MD
MSc
MSc
Maria Giovanna Vassallo
Maria Giovanna Vassallo
MD
MD
Maria Grazia Romeo MD
Maria Grazia Romeo MD
Alberto Bonadies
Alberto Bonadies
MD
MD
Antonio Longobardi
Antonio Longobardi
MD
MD
Francesco Pirozzi
Francesco Pirozzi
MD
MD
Pompea Bottiglieri
Pompea Bottiglieri
MD
MD
Annarita Iavazzo
Annarita Iavazzo
MD
MD
Leonardo De Luca
Leonardo De Luca
MD
MD
Enrico Coscioni
Enrico Coscioni
MD
MD

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