Application of transesophageal echocardiography in the monitor of allogeneic lung transplantation / 中华超声影像学杂志

ABSTRACT

Objective To investigate the application value of transesophageal echocardiography(TEE) in allogeneic lung transplantation. Methods The study enrolled 37 patients receiving allogeneic lung transplantation because of end stage lung disease,including sequential bilateral lung transplantation 20 cases and unilateral lung transplantation 17 cases,the latter included 4 cases with extracorporeal membrane oxygenation (ECM O).Echocardiographic parameters before surgery,including right ventricular transverse diameter (RVTD),left ventricular transverse diameter (LVTD),right atrial transverse diameter (RATD), left atrial transverse diameter (LATD),main pulmonary artery (DMPA),left ventricular ejection fraction (LVEF),pulmonary arterial systolic pressure (SPAP),and TEE parameters during surgery,including pulmonary artery anastomosis diameters (DRPAand/or DLPA) and blood flow velocity (VRPAand/or VLPA), pulmonary vein anastomosis blood flow velocity (V RPVand/or VLPV),were measured. Results ①Preoperative transthoracic echocardiographic showed a slight increase of right heart in patients with allogeneic lung transplantation,different degrees of increase in SPAP,a normal or slightly increase of D MPA and a normal LVEF,according to the ASE guidelines. ②Compared with pre-operation,the diameters of left and right pulmonary artery decreased ( P < 0.001) and the blood flow velocity of arteries and veins increased ( P <0.001). ③Patients with ECMO support had a higher SPAP before operation ( P <0.05) and a lower LVEF ( P <0.05),but within a normal range.The blood flow velocity of pulmonary artery and vein had no difference between two groups ( P > 0.05). Conclusions During allogeneic lung transplantation,TEE plays an important role in the monitor of pulmonary arteriovenous anastomosis. It could remind the surgeon whether anastomosis is narrow timely,and determine the patient′s hemodynamic status and cardiac load to guide the surgical process.