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Surgeon’s Paper Published in September Edition of Echocardiography

Renowned thoracic oncologist Shahriyour Andaz, MD, FACS, is the senior author of a paper that has been selected as the Continuing Medical Education (CME) article for the September 2013 edition of Echocardiography.

Dr. Andaz, South Nassau’s director of thoracic oncology and director of clinical research, co-authored the article, “A Systematic Review of Transesophageal Echocardiography-Induced Esophageal Perforation,” with Sandeep Sainathan, MD, FACS, department of thoracic surgery, Bronx-Lebanon Hospital Center, Bronx, NY.

Transesophageal echocardiography (TEE) is a valuable diagnostic tool that is used routinely to diagnose endocarditis (also called infective endocarditis (IE), endocarditis is an inflammation of the inner lining of the heart) and to evaluate the heart valves and heart function during open heart surgery. TEE is considered relatively safe and complications are uncommon, however, on a rare occasion the procedure can cause perforation of the esophagus. A perforation has a high morbidity and mortality rate and can cause mediastinitis, sepsis and multi-organ failure.

The article reports Drs. Andaz and Sainathan’s analysis of 35 cases of esophageal perforation from 22 studies. Their analysis found that TEE-induced esophageal perforation occurred predominantly in the thoracic esophagus segment, in elderly female patients, in an intra-operative setting and in cases with a perceived low risk or an uneventful TEE exam. The findings prompted Drs. Andaz and Sainathan to suggest that screening for high risk factors may not eliminate the occurrence of a perforation. Majority of the perforations can be repaired primarily with a good outcome, however, development of shock is associated with death from overwhelming infection. Dr. Andaz is board-certified in both thoracic and general surgery and specializes in complex chest cancer procedures and robotic-assisted and minimally invasive thoracoscopic surgery. He was the first surgeon on Long Island to perform robotic-assisted bilobectomy lung surgery and robotic-assisted surgical removal of the thymus gland. His expertise includes chest wall sarcoma resection and reconstruction, mesothelioma, tracheal resections and reconstructions, endobronchial surgery, esophageal resection and lung volume reduction surgery. Dr. Andaz is a five-time recipient of the Brooklyn and Long Island Chapter of the American College of Surgeons’ prestigious Murray Friedman Resident Competition (clinical research) Award.

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