INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF VASCULAR ANASTOMOSES IN LUNG TRANSPLANTATION - A REPORT ON 18 CASES

Citation
M. Michelcherqui et al., INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF VASCULAR ANASTOMOSES IN LUNG TRANSPLANTATION - A REPORT ON 18 CASES, Chest, 111(5), 1997, pp. 1229-1235
Citations number
11
Categorie Soggetti
Respiratory System
Journal title
ChestACNP
ISSN journal
00123692
Volume
111
Issue
5
Year of publication
1997
Pages
1229 - 1235
Database
ISI
SICI code
0012-3692(1997)111:5<1229:ITEAOV>2.0.ZU;2-E
Abstract
In patients after lung transplantation, dysfunction of pulmonary venou s and artery anastomoses leading to reoperation is described. Methods and results: Pulmonary artery and vein anastomoses were evaluated intr aoperatively by monoplane transesophageal echocardiography (TEE) in 18 patients undergoing lung transplantation (nine right, five left singl e lung transplantations, and four bilateral transplantations). All 13 right pulmonary artery anastomoses and all 22 pulmonary vein anastomos es could be visualized by TEE. None of the nine left pulmonary anastom oses could be visualized, Of the 13 right pulmonary anastomoses, 12 we re considered normal, their diameter ranging from 1 to 1.7 cm (mean, 1 .26+/-0.24 cm). A moderate stenosis of one pulmonary artery anastomosi s was identified but did not require reoperation, Of the 22 pulmonary vein anastomoses, 16 were considered normal, their diameter being >0.5 cm and the peak systolic flow velocity less than or equal to 1 m/s at the location of the anastomoses, In five cases, the anastomoses were not considered normal, but I reoperation was not indicated. In one cas e, a severe stenosis of pulmonary vein associated with graft dysfuncti on led to an early reoperation. Conclusion: Intraoperative TEE during lung transplantation contributes to the immediate evaluation of pulmon ary vein and light pulmonary artery anastomoses and allows immediate s urgical correction. Further investigations are necessary to establish threshold values requiring reoperation.