Transesophageal ultrasonography during orthotopic liver transplantation: Show me more.
Vetrugno LuigiFederico BarnariolElena BignamiGrazia D CentonzeAdelisa De FlaviisFederico PiccioniElisabetta AuciTiziana BovePublished in: Echocardiography (Mount Kisco, N.Y.) (2018)
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.
Keyphrases
- left ventricular
- patients undergoing
- ultrasound guided
- left atrial appendage
- magnetic resonance imaging
- hypertrophic cardiomyopathy
- pulmonary hypertension
- cardiac resynchronization therapy
- heart failure
- acute myocardial infarction
- aortic stenosis
- left atrial
- mitral valve
- contrast enhanced
- atrial fibrillation
- liver failure
- extracorporeal membrane oxygenation
- oxidative stress
- cardiac surgery
- respiratory failure
- drug induced
- computed tomography
- randomized controlled trial
- systematic review
- magnetic resonance
- intensive care unit
- acute kidney injury
- blood pressure
- acute respiratory distress syndrome
- catheter ablation