Dr. Shahriyour Andaz, the director of thoracic oncology and director of clinical research at South Nassau Communities Hospital, co-authored a paper on transesophageal echocardiography-induced esophageal perforation that was selected as the Continuing Medical Education article for the September 2013 issue of Echocardiography. The paper analyzed 35 cases of esophageal perforation from other studies and found they occurred predominantly in elderly women undergoing intra-operative TEE exams, even when the patient was perceived to be low risk. While most perforations can be repaired with a good outcome, the development of shock is associated with death from infection.

1. News
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October 16, 2013
Damian Becker, Manager of Media Relations
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Surgeon’s Paper Published in
September Edition of Echocardiography
Oceanside, N.Y. — 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, coauthored 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.

2. 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.
South Nassau Communities Hospital is one of the region’s largest hospitals, with 435 beds, more
than 1,000 physicians and 3,000 employees. Located in Oceanside, NY, the hospital is an acute-care,
not-for-profit teaching hospital that provides state-of-the-art care in cardiac, oncologic, orthopedic,
bariatric, pain management, mental health and emergency services. In addition to its extensive outpatient
specialty centers, South Nassau provides emergency and elective angioplasty and is the only hospital on
Long Island with the Novalis Tx™ and Gamma Knife® Perfexion radiosurgery technologies. South
Nassau is a designated Stroke Center by the New York State Department of Health and Comprehensive
Community Cancer Center by the American College of Surgeons and is recognized as a Bariatric Surgery
Center of Excellence by the American Society for Metabolic and Bariatric Surgery. For more
information, visit www.southnassau.org.
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