Premium
Transesophageal ultrasonography during orthotopic liver transplantation: Show me more
Author(s) -
Vetrugno Luigi,
Barnariol Federico,
Bignami Elena,
Centonze Grazia D.,
De Flaviis Adelisa,
Piccioni Federico,
Auci Elisabetta,
Bove Tiziana
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14037
Subject(s) - medicine , cardiology , perioperative , patent foramen ovale , hypoxemia , liver transplantation , ventricular outflow tract , transplantation , radiology , surgery , migraine
The first perioperative transesophageal echocardiography ( TEE ) guidelines published 21 years ago were mainly addressed to cardiac anesthesiologists. TEE has since expanded its role outside this setting and currently represents an invaluable tool to assess chamber sizes, ventricular hypertrophy, and systolic, diastolic, and valvular function in patients undergoing orthotopic liver transplantation ( OLT ). Right‐sided microemboli, right ventricular dysfunction, and patent foramen ovale ( PFO ) are the most common intra‐operative findings described during OLT . However, left ventricular outflow tract obstruction and left ventricular ballooning syndrome are more difficult to recognize and less frequent. Transesophageal ultrasonography ( TEU ) during OLT is also underused. Its applications are as follows: (1) assistance in the difficult placement of pulmonary arterial catheters; (2) help with catheterization of great vessels for external veno‐venous bypass placement; (3) intra‐operative evaluation of surgical liver anastomosis patency, if feasible, through the liver window; and (4) intra‐operative investigation of “acute hypoxemia” due to pulmonary and cardiac issues using trans‐esophageal lung ultrasound ( TELU ). The aims of this review are as follows: (1) to summarize the uses of TEE and TEU throughout all phases of OLT , and (2) to describe other new feasible applications.