Femoral Vein Pulsatility: What Does It Mean?

Abstract

In this report, the clinical evolution of a 72-year-old patient transferred to the surgical intensive care unit after cardiac surgery is described. The presence of a pulsatile Doppler signal of the common femoral vein was noted after surgery. On postoperative day 5, diuretics in addition to a combination of inhaled epoprostenol and milrinone were associated with normalization of femoral vein pulsatility. The observations seen in peripheral venous flow reinforce the hypothesis that pulsatility of the common femoral vein represents an associated echocardiographic sign of right ventricular dysfunction and may be used to monitor systemic venous congestion. Pulsatility in the venous system may be improved by reducing volume overload and improving right ventricular function.

Pulsatile Femoral Vein Doppler and Congestive Delirium, What Is the Relationship?: A Case Report

“…In the presence of more severe elevation of the right atrial pressure with or without significant tricuspid regurgitation, systolic reversal of the venous Doppler waveform will be observed (Figure 2C). Those signals can also correlate with other venous Doppler signs of venous congestion like those observed with pulmonary hypertension, 10 pericardectomy, 11 and right heart failure, 12 which are mainly determined by increased backward venous pressure. The association between portal venous pulsatility and delirium has been reported 5,6 but not using femoral venous Doppler, which may represent a simpler and faster technique to detect congestive delirium.…”

Downstream Effects: Promise and Challenges of Femoral Vein Pulsatility Assessment

“…Calderone et al 2 at the Montreal Heart Institute presented a case report and discussion describing the clinical use of this correlation of venous reversal with right-sided heart dysfunction. An elderly patient with multiple indicators of severe postoperative right-sided heart dysfunction was found to have femoral venous flow reversal on pulsed-wave Doppler.…”