- 期刊
- OpenAccess
Intraoperative transesophageal echocardiographic detection of intracardiac thrombus and pulmonary embolism during orthotopic liver transplant
並列摘要
Introduction: Transesophageal echocardiography (TEE) utilization during liver transplantation is beginning to gain favor in many medical centers. The intraoperative course during liver transplant includes periods of increased and decreased peripheral vascular resistance, large amounts of third spacing, high volume replacement needs, and the possibility of acute right heart failure and circulatory collapse at reperfusion. Additionally, these patients may have underlying systolic dysfunction and coronary artery disease. Intraoperative TEE provides the anesthesiologist with the only single monitoring modality that can be used to diagnose all of these. Fear of bleeding complications due to esophageal varices, and the lack of provider competency with TEE are often sited as reasons to avoid TEE in this patient population. Case Report: This is a case of an intracardiac thrombus and pulmonary embolism in a 44-year-old male undergoing orthotopic liver transplantation for Laennec’s cirrhosis. Conclusion: In this case, the routine use of intraoperative TEE provided for diagnosis of a massive intracardiac thrombus and pulmonary embolism during the dissection phase of liver transplantation, adding to the growing body of case reports supporting TEE as a diagnostic tool during orthotopic liver transplantation.
延伸閱讀
- Juang, S. E., Lai, H. C., Lan, Y. C., Liu, T. J., & Lai, H. C. (2005). Left Atrial Infective Endocarditis with Giant Vegetation without Involvement of the Mitral Valve-A Case Report of Transesophageal Echocardiography in Diagnosis. Acta Anaesthesiologica Taiwanica, 43(3), 165-167. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200509-43-3-165-167-a
- Jain, S. K. A., Patel, B., David, W., Jazrawi, A., & Alexander, P. (2014). Unloading of Right Ventricle and Clinical Improvement after Ultrasound-Accelerated Thrombolysis in Patients with Submassive Pulmonary Embolism. Case Reports in Medicine, 2014(), 210-217-048. https://doi.org/10.1155/2014/297951
- Chan, K. C., Lin, Z. Y., Chen, T. H., Huang, Y. C., Wang, M. J., & Tsait, S. K. (2002). Transesophageal Echocardiographic Monitoring of Critical Left Ventricular Outflow Tract Obstruction Following Mitral Xenograft Replacement -A Case Report. Acta Anaesthesiologica Sinica, 40(2), 81-84. https://doi.org/10.6955/AAS.200206.0081
- Chen, Y. C., Hong, T. C., & Hou, C. J. Y. (2003). Transesophageal Echocardiography in the Detection of Prosthetic Mitral Valve Thrombosis Caused by Inadequate Anticoagulation. Journal of Medical Ultrasound, 11(3), 111-114. https://www.airitilibrary.com/Article/Detail?DocID=09296441-200309-11-3-111-114-a
- Han, Y. Y., Cheng, Y. J., Liao, W. W., Ko, W. J., & Tsai, S. K. (2003). Delayed Diagnosis of Esophageal Perforation Following Intraoperative Transesophageal Echocardiography during Valvular Replacement-A Case Report. Acta Anaesthesiologica Sinica, 41(2), 81-84. https://doi.org/10.6955/AAS.200306.0081