Another Cause for Mallory Weiss Tear - Transesophageal Echo during CABG

<p>Transesophageal echocardiogram (TEE) is a valuable diagnostic tool commonly used during surgical procedures to assess cardiac structures. Although generally safe, rare complications like esophageal bleeding (0.14% incidence) can occur. Here, we present a unique case of a Mallory-Weiss tear (MWT) secondary to intraoperative TEE in a patient undergoing coronary artery bypass grafting (CABG).  MWTs are non-perforating mucosal tears often caused by sudden increases in intra-abdominal pressure; iatrogenic factors such as TEE can also contribute. Proposed mechanisms of TEE-related esophageal injury include prolonged contact between the esophagus and probe and the extended duration of a flexed probe during continuous LV function monitoring as well as fibrinolytic therapy immediately following a TEE, which may be associated with an increased risk of bleeding.</p>