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Case Report
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| Intraoperative transesophageal echocardiographic detection of intracardiac thrombus and pulmonary embolism during orthotopic liver transplant | ||||||
| Amie Hoefnagel | ||||||
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Assistant Professor of Anesthesiology, Department of Anesthesiology, University of Rochester School of Medicine, Rochester NY, USA.
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| How to cite this article |
| Hoefnagel A. Intraoperative transesophageal echocardiographic detection of intracardiac thrombus and pulmonary embolism during orthotopic liver transplant. Int J Case Rep Images 2015;6(6):348–351. |
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Abstract
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Introduction:
Transesophageal echocardio-graphy (TEE) utilization during liver transplantation is beginning to gain favor in many medical centers. The intraoperative course during liver transplant includes periods of increased and decreased peripheral vascular resistance, large amounts of third spacing, high volume replacement needs, and the possibility of acute right heart failure and circulatory collapse at reperfusion. Additionally, these patients may have underlying systolic dysfunction and coronary artery disease. Intraoperative TEE provides the anesthesiologist with the only single monitoring modality that can be used to diagnose all of these. Fear of bleeding complications due to esophageal varices, and the lack of provider competency with TEE are often sited as reasons to avoid TEE in this patient population.
Case Report: This is a case of an intracardiac thrombus and pulmonary embolism in a 44-year-old male undergoing orthotopic liver transplantation for Laennec's cirrhosis. Conclusion: In this case, the routine use of intraoperative TEE provided for diagnosis of a massive intracardiac thrombus and pulmonary embolism during the dissection phase of liver transplantation, adding to the growing body of case reports supporting TEE as a diagnostic tool during orthotopic liver transplantation. | |
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Keywords:
Intracardiac thrombus, Orthotopic liver transplantation, Pulmonary embolism, Transesophageal echocardiography
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Author Contributions
Amie Hoefnagel – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Amie Hoefnagel. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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About The Author
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