TY - JOUR
T1 - Intraoperative transesophageal echocardiography during liver transplantation
AU - Suriani, R. J.
AU - Cutrone, A.
AU - Feierman, D.
AU - Konstadt, S.
PY - 1996
Y1 - 1996
N2 - Objective: To investigate the safety, value, and impact of transesophageal echocardiography during liver transplantation. Design: Retrospective. Setting: University teaching hospital. Participants and Interventions: The medical records of 346 patients and the videotapes of 100 intraoperative transesophageal echocardiography examinations were reviewed. Measurements and Main Results: Transesophageal echocardiography was indicated for intraoperative monitoring in 62 patients, 41 of whom had pertinent findings, and for diagnostic purposes in 38 patients, 14 of whom had the expected diagnosis verified. Thirty-one patients had no intraoperative findings. Information that would not have been detected intraoperatively by other means included intracardiac defects, the potential for transpulmonary air passage, valvular regurgitation, the presence or absence of ventricular dysfunction, and embolization occurring at allograft reperfusion. Unanticipated findings during the initial transesophageal echocardiography examination as well as evaluation of intraoperative events resulted in a major impact on patient management in 11% of patients. Preoperatively, 64 patients had a prothrombin time greater than 14 seconds; 56 had a platelet count less than 100,000/mm3; and 23 had esophageal varices, 7 of whom had not had variceal sclerotherapy. Two patients had a complication possibly caused by transesophageal echocardiography (sinus bradycardia and upper gastrointestinal bleeding]. No patient experienced documented variceal hemorrhage, esophageal or gastric perforation, and/or oropharyngeal trauma. Conclusions: It appears that transesophageal echocardiography can be performed safely in patients undergoing liver transplantation, is efficacious in rapidly disclosing new information and monitoring during periods of hemodynamic instability, and may have a significant impact on intraoperative patient management during liver transplantation.
AB - Objective: To investigate the safety, value, and impact of transesophageal echocardiography during liver transplantation. Design: Retrospective. Setting: University teaching hospital. Participants and Interventions: The medical records of 346 patients and the videotapes of 100 intraoperative transesophageal echocardiography examinations were reviewed. Measurements and Main Results: Transesophageal echocardiography was indicated for intraoperative monitoring in 62 patients, 41 of whom had pertinent findings, and for diagnostic purposes in 38 patients, 14 of whom had the expected diagnosis verified. Thirty-one patients had no intraoperative findings. Information that would not have been detected intraoperatively by other means included intracardiac defects, the potential for transpulmonary air passage, valvular regurgitation, the presence or absence of ventricular dysfunction, and embolization occurring at allograft reperfusion. Unanticipated findings during the initial transesophageal echocardiography examination as well as evaluation of intraoperative events resulted in a major impact on patient management in 11% of patients. Preoperatively, 64 patients had a prothrombin time greater than 14 seconds; 56 had a platelet count less than 100,000/mm3; and 23 had esophageal varices, 7 of whom had not had variceal sclerotherapy. Two patients had a complication possibly caused by transesophageal echocardiography (sinus bradycardia and upper gastrointestinal bleeding]. No patient experienced documented variceal hemorrhage, esophageal or gastric perforation, and/or oropharyngeal trauma. Conclusions: It appears that transesophageal echocardiography can be performed safely in patients undergoing liver transplantation, is efficacious in rapidly disclosing new information and monitoring during periods of hemodynamic instability, and may have a significant impact on intraoperative patient management during liver transplantation.
KW - impact
KW - liver transplantation
KW - safety
KW - transesophageal echocardiography
KW - value
UR - http://www.scopus.com/inward/record.url?scp=0029966231&partnerID=8YFLogxK
U2 - 10.1016/S1053-0770(96)80193-5
DO - 10.1016/S1053-0770(96)80193-5
M3 - Article
C2 - 8910147
AN - SCOPUS:0029966231
SN - 1053-0770
VL - 10
SP - 699
EP - 707
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 6
ER -