Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography.
<h4>Background</h4>The pathophysiology of advanced liver cirrhosis may induce alterations in the circulatory system that may be challenging for the anesthesiologist to manage intraoperatively, and perioperative cardiovascular events are associated with worse outcomes in cirrhotic patient...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0275301 |
| _version_ | 1798019436389597184 |
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| author | Glauber Gouvêa John Feiner Sonali Joshi Rodrigo Diaz Jose Eduardo Ferreira Manso Alexandra Rezende Assad Ismar Lima Cavalcanti Marcello Fonseca Salgado-Filho Aline D'Avila Pereira Nubia Verçosa |
| author_facet | Glauber Gouvêa John Feiner Sonali Joshi Rodrigo Diaz Jose Eduardo Ferreira Manso Alexandra Rezende Assad Ismar Lima Cavalcanti Marcello Fonseca Salgado-Filho Aline D'Avila Pereira Nubia Verçosa |
| author_sort | Glauber Gouvêa |
| collection | DOAJ |
| description | <h4>Background</h4>The pathophysiology of advanced liver cirrhosis may induce alterations in the circulatory system that may be challenging for the anesthesiologist to manage intraoperatively, and perioperative cardiovascular events are associated with worse outcomes in cirrhotic patients undergoing liver transplantation. It remains controversial whether right ventricular function is impaired during this procedure. Studies using transesophageal echocardiography for quantitative analysis of the right ventricle remain scarce in this setting, yielding conflicting results. The aim of this study was to perform a quantitative assessment of right ventricular function with two parameters derived from transesophageal echocardiography during liver transplantation.<h4>Methods</h4>Nineteen adult patients of both genders undergoing liver transplantation were evaluated in this observational study. The exclusion criteria were age under 18 or above 65 years old, fulminant hepatic failure, hepatopulmonary syndrome, portopulmonary hypertension, cardiopulmonary disease, and contraindications to the transesophageal echocardiogram. Right ventricular function was assessed at five stages during liver transplantation: baseline, hepatectomy, anhepatic, postreperfusion, and closure by measuring tricuspid annular plane systolic excursion and right ventricular fractional area change obtained with transesophageal echocardiography.<h4>Results</h4>Right ventricular function was found to be normal throughout the procedure. The tricuspid annular plane systolic excursion showed a trend toward a decrease in the anhepatic phase compared to baseline (2.0 ± 0.9 cm vs. 2.4 ± 0.7 cm; P = 0.24) but with full recovery after reperfusion. Right ventricular fractional area change remained nearly constant during all stages studied (minimum: 50% ± 10 at baseline and anhepatic phase; maximum: 56% ± 12 at postreperfusion; P = 0.24).<h4>Conclusions</h4>Right ventricular function was preserved during liver transplantation at the time points evaluated by two quantitative parameters derived from transesophageal echocardiogram. |
| first_indexed | 2024-04-11T16:39:08Z |
| format | Article |
| id | doaj.art-5ebe71537b23467684bc8c67a4f1d100 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T16:39:08Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-5ebe71537b23467684bc8c67a4f1d1002022-12-22T04:13:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011710e027530110.1371/journal.pone.0275301Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography.Glauber GouvêaJohn FeinerSonali JoshiRodrigo DiazJose Eduardo Ferreira MansoAlexandra Rezende AssadIsmar Lima CavalcantiMarcello Fonseca Salgado-FilhoAline D'Avila PereiraNubia Verçosa<h4>Background</h4>The pathophysiology of advanced liver cirrhosis may induce alterations in the circulatory system that may be challenging for the anesthesiologist to manage intraoperatively, and perioperative cardiovascular events are associated with worse outcomes in cirrhotic patients undergoing liver transplantation. It remains controversial whether right ventricular function is impaired during this procedure. Studies using transesophageal echocardiography for quantitative analysis of the right ventricle remain scarce in this setting, yielding conflicting results. The aim of this study was to perform a quantitative assessment of right ventricular function with two parameters derived from transesophageal echocardiography during liver transplantation.<h4>Methods</h4>Nineteen adult patients of both genders undergoing liver transplantation were evaluated in this observational study. The exclusion criteria were age under 18 or above 65 years old, fulminant hepatic failure, hepatopulmonary syndrome, portopulmonary hypertension, cardiopulmonary disease, and contraindications to the transesophageal echocardiogram. Right ventricular function was assessed at five stages during liver transplantation: baseline, hepatectomy, anhepatic, postreperfusion, and closure by measuring tricuspid annular plane systolic excursion and right ventricular fractional area change obtained with transesophageal echocardiography.<h4>Results</h4>Right ventricular function was found to be normal throughout the procedure. The tricuspid annular plane systolic excursion showed a trend toward a decrease in the anhepatic phase compared to baseline (2.0 ± 0.9 cm vs. 2.4 ± 0.7 cm; P = 0.24) but with full recovery after reperfusion. Right ventricular fractional area change remained nearly constant during all stages studied (minimum: 50% ± 10 at baseline and anhepatic phase; maximum: 56% ± 12 at postreperfusion; P = 0.24).<h4>Conclusions</h4>Right ventricular function was preserved during liver transplantation at the time points evaluated by two quantitative parameters derived from transesophageal echocardiogram.https://doi.org/10.1371/journal.pone.0275301 |
| spellingShingle | Glauber Gouvêa John Feiner Sonali Joshi Rodrigo Diaz Jose Eduardo Ferreira Manso Alexandra Rezende Assad Ismar Lima Cavalcanti Marcello Fonseca Salgado-Filho Aline D'Avila Pereira Nubia Verçosa Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography. PLoS ONE |
| title | Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography. |
| title_full | Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography. |
| title_fullStr | Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography. |
| title_full_unstemmed | Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography. |
| title_short | Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography. |
| title_sort | evaluation of right ventricular function during liver transplantation with transesophageal echocardiography |
| url | https://doi.org/10.1371/journal.pone.0275301 |
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