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Canadian Journal of Anesthesia

, Volume 49, Issue 10, pp 1081–1083 | Cite as

Transesophageal echocardiography in the management of left atrio-femoral bypass during thoracoabdominal aortic aneurysm repair: a case report

  • Ashraf Fayad
  • Corey Sawchuk
  • Homer Yang
  • Claudio Cina
Cardiothoracic Anesthesia, Respiration and Airway
Accepted:

Abstract

Purpose

To describe the utility of transesophageal echocardiography (TEE) in a patient undergoing thoracoabdominal aneurysm (TAA) surgery using left atrio-femoral bypass (LAFB).

Clinical features

A 57-yr-old female patient underwent repair of type II TAA, As per institutional routine, LAFB technique was used. Initial difficulty with the pump flow was encountered, TEE images showed that the left atrial cannula was positioned against the left atrial wall. The cannula position was adjusted and the pump flow was established. During different stages of the surgery, TEE was used to monitor the left ventricular cavity size and its function. This allowed the adjustment of LAFB pump flow relative to left ventricular filling and optimal fluid resuscitation in order to maintain both upper and lower body perfusion.

Conclusion

In this patient, TEE was useful to confirm the correct position of the left atrial cannula and for hemodynamic management during LAFB.

Keywords

Transesophageal Echocardiography Pump Flow Left Atrial Wall Thoracoabdominal Aneurysm Left Ventricular Cavity Size 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

L’échocardiographie transœsophagienne dans la conduite du pontage auriculo-fémoral pendant la réparation d’un anévrysme de l’aorte thoraco-abdominale : une observation

Résumé

Objectif

Décrire l’utilité de l’échocardiographie transœsophagienne (ETO) chez une femme subissant la réparation d’un anévrysme thoraco-abdominal (ATA) par pontage auriculo-fémoral gauche (PAFG).

Éléments cliniques

Une femme de 57 ans devait subir la réparation d’un ATA de type II. Suivant la pratique courante de l’institution, une technique de PAFG a été utilisée. Une première difficulté s’est présentée avec le débit de la pompe. Les images de l’ETO ont montré que la canuie auriculaire gauche était placée sur la paroi auriculaire gauche. La canule a été replacée et le débit de la pompe a été établi. À différentes étapes de l’intervention, l’ETO a été utilisée pour surveiller la taille de la cavité ventricuiaire gauche et sa fonction. Cet examen a permis l’ajustement du débit de la pompe de PAFG relativement au remplissage du ventricule gauche et au remplacement de liquide optimal afin de maintenir la perfusion du tronc supérieur et inférieur.

Conclusion

L’ETO a permis de confirmer la position correcte de la canule auriculaire gauche et de surveiller l’hémodynamique pendant le PAFG.

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Copyright information

© Canadian Anesthesiologists 2002

Authors and Affiliations

  • Ashraf Fayad
    • 1
  • Corey Sawchuk
  • Homer Yang
  • Claudio Cina
  1. 1.Department of AnesthesiaMcMaster University, Hamilton Health SciencesHamiltonCanada

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