Guiding Surgical Cannulation of the Inferior Vena Cava with Transesophageal Echocardiography

Kirkeby‐Garstad, Idar; Tromsdal, Arve; Sellevold, Olav F Münter; Bjørngaard, M.; Bjella, Lise; Berg, Einar M.; Karevold, Asbjørn; Haaverstad, Rune; Wahba, Alexander; Tjomsland, Ole; Astudillo, Rafael; Krogstad, Arne; Stenseth, Roar

doi:10.1213/01.ane.0000055361.50727.11

Cited by 37 publications

(28 citation statements)

References 6 publications

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“…2) and e.g. for femoral remote cannulation to -check with TEE the position of the guide wire within the superior vena cava before insertion of the collapsed smart canula W (stretched over the corresponding mandrel), -follow with TEE the positioning of the tip of the smart canula W within the superior vena cava [13,14], -remove the guide wire with the mandrel still in place, in order to prevent smart canula W tip migration (Fig. 3), and -finally to monitor with TEE the expansion of the smart canula W during removal of the mandrel.…”

Section: Discussionmentioning

confidence: 99%

Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases☆

Segesser¹,

Ferrari²,

Delay³

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases☆

Segesser¹,

Ferrari²,

Delay³

et al. 2008

European Journal of Cardio-Thoracic Surgery

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“…The left and middle hepatic veins join to form a single vein before entering the IVC in 60-86 % of people [8,9]. Using TEE, Kirkeby-Garstad et al reported good liver anatomy visualization and an acceptable-quality image of the IVC and the RHV in 95 and 87 % of cases, respectively [10]. Meierhenrich et al [11], on the other hand, studied 34 patients scheduled for abdominal surgery and using multiplane TEE, they successfully identified the three main hepatic veins in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…Doppler ultrasound tracing forms a fundamental component of a complete TEE examination of the liver, and spectral Doppler tracing from the hepatic veins can provide important information about cardiac and hepatic pathology [10]. A typical Doppler trace consists of three phases and four peaks: A, S, V, and D; where the S and D waveforms indicate blood flow in the anterograde direction toward the heart Fig.…”

Section: Discussionmentioning

confidence: 99%

Could transesophageal echocardiography be useful in selected cases during liver surgery resection?

et al. 2014

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Purpose Although only limited scientific evidence exists promoting the use of transesophageal echocardiography (TEE) in non cardiac surgery, several recent studies have documented its usefulness during liver surgery. Methods and resultsIn the present case study, through the use of color Doppler TEE, compression of the inferior vena cava and the right hepatic vein was clearly evident, as was their restoration after surgery. Conclusion TEE should be encouraged in patients undergoing liver resection, not only for hemodynamic monitoring, but also for its ability to provide information about the anatomy of the liver, its vessels, and inferior vena cava patency.Keywords Transesophageal echocardiography Á Liver surgery Á Hepatic angioma Á Hemodynamic monitoring Riassunto Il fegato può essere coinvolto da una varietà di patologie, che vanno dalle lesioni benigne come l'angioma epatico, che possono necessitare di essere resecate, all'insufficienza epatica per la quale l'unica terapia possible è il trapianto di fegato. Benchè ci siano solo limitate evidenze scientifiche che supportino l'utilizzo dell'ecografia transesofagea (TEE) nella chirurgia non cardiaca, alcuni studi hanno documentato la sua utilità durante la chirurgia epatica. Nel caso in studio, attraverso l'uso del color Doppler TEE la compressione della vena cava inferiore a della vena epatica destra erano visualizzate così come le loro dimensioni dopo l'intervento chirurgico. Per tale motivo l'utilizzo del TEE dovrebbe essere incoraggiato nei pazienti che vanno incontro a resezione epatica non solo come strumento di valuatzione emodinamica ma anche per la sua abilità di dare informazioni utili sull'anatomia del fegato dei suoi vasi e sulla pervietà della vena cava.

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“…Remnants of the Chiari complex (Fig. 4.12) manifested as either a Eustachian valve or Thebesian valve [6] may explain why the cardiac surgeon may have had difficulty passing the venous cannula [7] into the superior vena cava or a retrograde cardioplegia catheter into the coronary sinus [8], respectively. …”

Section: Right Atriummentioning

confidence: 99%

The Cardiac Dissection

Houser

2009

The Operated Heart at Autopsy

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An approach is offered here to assist the pathologist with the actual dissection of the operated heart at autopsy. The challenge to the pathologist is to define any underlying cardiac pathology, recognize changes in morphology brought about by prior surgical intervention, and correlate the gross cardiac findings with the hemodynamic status of the deceased prior to death. Even without detailed clinical records, one can still perform the dissection in a consistent and careful manner that allows an accurate assessment of the heart regardless of postoperative adhesions and complex surgical reconstructions. Developing the plane of dissection between the heart and adherent parietal pericardium should be done with a scalpel, using a methodical technique. As one examines the external surface of the heart, one may observe clues that the surgeon had used cardiopulmonary bypass to rest the heart during surgery and that specific surgical procedures had been performed. By removal of the coronary arteries with any bypass grafts off the heart and subsequent careful examination of the chambers and great vessels of the heart, the pathologist can then begin to understand the "real story." Keywords Dissection · Pericardium · Heart surgery · Coronary arteries · Surgical footprints · Cardiopulmonary bypass · Sharp dissection In this chapter, an approach is offered to assist the pathologist with the actual dissection of the operated heart at autopsy. This dissection, depending on what operation was done and how long prior to autopsy the operation was performed, may range in complexity from a simple procedure to quite a daunting task. The challenge to the pathologist is to define any underlying cardiac pathology, recognize changes in morphology brought about by prior surgical intervention, and correlate the gross cardiac findings with the hemodynamic status of the deceased prior to death. In short, to what extent did failure of cardiac function contribute to the person's death, and how did the previous heart surgery affect the outcome of the case?Having a detailed knowledge of the deceased's past surgical history, as provided by operative notes, hospital discharge summaries, and available informed clinicians is an obvious advantage to the pathologist at autopsy. However, even without this 31 S.L. Houser, The Operated Heart at Autopsy,

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Guiding Surgical Cannulation of the Inferior Vena Cava with Transesophageal Echocardiography

Cited by 37 publications

References 6 publications

Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases☆

Routine use of self-expanding venous cannulas for cardiopulmonary bypass: benefits and pitfalls in 100 consecutive cases☆

Could transesophageal echocardiography be useful in selected cases during liver surgery resection?

The Cardiac Dissection

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