Cardiology Assessment of Patients Undergoing Evaluation for Orthotopic Liver Transplantation

Lee, Michael S.; Wadia, Subeer; Yeghiazarians, Yerem; Matthews, Ray V.; White, Christopher J.; Herrmann, Howard C.; O’Donnell, William H.; McPherson, John; Leesar, Massoud A.; Kreutz, Rolf P.; Brandman, Danielle; Gupta, Anuj; Mandras, Stacy A.; Kandzari, David E.

doi:10.1016/j.jscai.2022.100528

Cited by 2 publications

(1 citation statement)

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“…Liver transplantation could be considered a procedure with a higher embolic risk in this context. The placement of central lines, veno-venous bypass, caval clamping, and liver graft reperfusion are some of the procedures that lead to thrombotic or gas emboli formation [18,23]. In addition, coagulation disorders related to end-stage liver disease predispose one to the development of thromboembolism.…”

Section: Discussionmentioning

confidence: 99%

Transcranial Doppler Ultrasound and Transesophageal Echocardiography for Intraoperative Diagnosis and Monitoring of Patent Foramen Ovale in Non-Cardiac Surgery

Bianchini,

Vitale,

Romano

et al. 2024

Applied Sciences

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Background: perioperative stroke is one of the major complications after surgery. Patent foramen ovale (PFO) increases the risk of stroke in non-cardiac surgery by right-to-left shunt related to intraoperative hemodynamic alterations, leading to paradoxical embolism. Transesophageal echocardiography is the best tool for obtaining anatomical confirmation of PFO and essential details such as the PFO measure and the degree and direction of the shunt. Despite this, preoperative PFO screening is not routinely performed. Methods and results: we described the features of ten consecutive patients undergoing major abdominal surgery at the Abdominal Organ Transplant Intensive Care Unit, IRCCS Sant’Orsola, Bologna, Italy, who were screened for PFO using a PFO diagnostic and monitoring standardized intraoperative protocol by transesophageal echocardiography and transcranial color Doppler ultrasound. Finally, we highlighted the neurological and respiratory outcomes, the course and the management of three patients with intracardiac and extracardiac shunts. Conclusions: identifying an unknown PFO by a TCCD-TEE approach allowed the intraoperative monitoring of the shunt direction. It prevents the risk of complications secondary to paradoxical embolism in non-cardiac high-embolic-risk surgery.

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Section: Discussionmentioning

confidence: 99%