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Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center

Background: Hemodynamic instability (HDI) is common during liver transplantation (LT); veno-venous bypass (VVB) is a tool used in selected cases to ensure hemodynamic stability and for surgical needs. Transesophageal echocardiography (TEE) allows the transplant team to identify the causes of HDI and...

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Autores principales: Bianchini, Amedeo, Laici, Cristiana, Bordini, Martina, Bianchin, Matteo, Silvas, Catalin Iustin Ioan, Cescon, Matteo, Ravaioli, Matteo, Vitale, Giovanni, Siniscalchi, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866160/
https://www.ncbi.nlm.nih.gov/pubmed/36661927
http://dx.doi.org/10.3390/jcdd10010032
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author Bianchini, Amedeo
Laici, Cristiana
Bordini, Martina
Bianchin, Matteo
Silvas, Catalin Iustin Ioan
Cescon, Matteo
Ravaioli, Matteo
Vitale, Giovanni
Siniscalchi, Antonio
author_facet Bianchini, Amedeo
Laici, Cristiana
Bordini, Martina
Bianchin, Matteo
Silvas, Catalin Iustin Ioan
Cescon, Matteo
Ravaioli, Matteo
Vitale, Giovanni
Siniscalchi, Antonio
author_sort Bianchini, Amedeo
collection PubMed
description Background: Hemodynamic instability (HDI) is common during liver transplantation (LT); veno-venous bypass (VVB) is a tool used in selected cases to ensure hemodynamic stability and for surgical needs. Transesophageal echocardiography (TEE) allows the transplant team to identify the causes of HDI and to guide therapies. We present a case series of four patients showing the valuable role of TEE during LT in VVB. Methods: We report four explicative cases of TEE use in LT with VVB performed at IRCCS Azienda Ospedaliero–Universitaria di Bologna. Four transplants were performed between 2016 and 2022. Results: Many authors have highlighted the diagnostic value of TEE during LT in the case of HDI. However, its specific role during LT with VVB is poorly described. This paper illustrates multiple potential uses of TEE in LT with VVB: TEE as a guide for catheterization and optimal cannula positioning, TEE as a tool for intraoperative Patent Foramen Ovale management, TEE as help for anticoagulation therapy and finally, TEE as support when evaluating bypass efficiency and correcting hypovolemia. Conclusion: TEE is a useful instrument during LT with VVB. However, further studies are needed to assess the suitable applications of TEE during LT in patients with HDI requiring VVB. TEE should be part of the anesthetist’s cultural background.
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spelling pubmed-98661602023-01-22 Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center Bianchini, Amedeo Laici, Cristiana Bordini, Martina Bianchin, Matteo Silvas, Catalin Iustin Ioan Cescon, Matteo Ravaioli, Matteo Vitale, Giovanni Siniscalchi, Antonio J Cardiovasc Dev Dis Case Report Background: Hemodynamic instability (HDI) is common during liver transplantation (LT); veno-venous bypass (VVB) is a tool used in selected cases to ensure hemodynamic stability and for surgical needs. Transesophageal echocardiography (TEE) allows the transplant team to identify the causes of HDI and to guide therapies. We present a case series of four patients showing the valuable role of TEE during LT in VVB. Methods: We report four explicative cases of TEE use in LT with VVB performed at IRCCS Azienda Ospedaliero–Universitaria di Bologna. Four transplants were performed between 2016 and 2022. Results: Many authors have highlighted the diagnostic value of TEE during LT in the case of HDI. However, its specific role during LT with VVB is poorly described. This paper illustrates multiple potential uses of TEE in LT with VVB: TEE as a guide for catheterization and optimal cannula positioning, TEE as a tool for intraoperative Patent Foramen Ovale management, TEE as help for anticoagulation therapy and finally, TEE as support when evaluating bypass efficiency and correcting hypovolemia. Conclusion: TEE is a useful instrument during LT with VVB. However, further studies are needed to assess the suitable applications of TEE during LT in patients with HDI requiring VVB. TEE should be part of the anesthetist’s cultural background. MDPI 2023-01-16 /pmc/articles/PMC9866160/ /pubmed/36661927 http://dx.doi.org/10.3390/jcdd10010032 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Bianchini, Amedeo
Laici, Cristiana
Bordini, Martina
Bianchin, Matteo
Silvas, Catalin Iustin Ioan
Cescon, Matteo
Ravaioli, Matteo
Vitale, Giovanni
Siniscalchi, Antonio
Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center
title Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center
title_full Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center
title_fullStr Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center
title_full_unstemmed Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center
title_short Using Transesophageal Echocardiography in Liver Transplantation with Veno-Venous Bypass Is a Tool with Many Applications: A Case Series from an Italian Transplant Center
title_sort using transesophageal echocardiography in liver transplantation with veno-venous bypass is a tool with many applications: a case series from an italian transplant center
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866160/
https://www.ncbi.nlm.nih.gov/pubmed/36661927
http://dx.doi.org/10.3390/jcdd10010032
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