Guiding Surgical Cannulation of the Inferior Vena Cava with Transesophageal Echocardiography
| Autor: | Olav F.M. Sellevold, Rafael Astudillo, Einar M. Berg, Ole Tjomsland, Arve Tromsdal, Asbjørn Karevold, Alexander Wahba, Idar Kirkeby-Garstad, Rune Haaverstad, Mads Björngaard, Arne Krogstad, Lise Bjella, Roar Stenseth |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Vena Cava Inferior Hepatic Veins Inferior vena cava law.invention law Catheterization Peripheral Cardiopulmonary bypass Humans Medicine Cardiac Surgical Procedures Vein Sex Characteristics business.industry digestive oral and skin physiology Middle Aged Cannula Surgery Cardiac surgery Eustachian Valve Anesthesiology and Pain Medicine medicine.anatomical_structure medicine.vein Hepatic veins cardiovascular system Female Radiology business Echocardiography Transesophageal Venous return curve |
| Zdroj: | Anesthesia & Analgesia. :1288-1293 |
| ISSN: | 0003-2999 |
| DOI: | 10.1213/01.ane.0000055361.50727.11 |
| Popis: | We studied 150 adult cardiac surgery patients to assess visualization of the venous cannula and the venous system by intraoperative transesophageal echocardiography and to register the incidence of cannulation of hepatic veins. The quality of images, the dimensions of the venous system, the position of the venous cannula, and the adequacy of venous return were registered. Acceptable image quality of the inferior vena cava and the right hepatic vein (RHV) was obtained in 95% and 87% of cases, respectively. Considerable individual variations were found in the dimensions of the venous system. The cannula position could be determined in 99% of the cases. Ten percent of venous cannulae were primarily placed in the RHV. A short distance between the eustachian valve and the RHV possibly predisposes to cannulation of the RHV. No other patient-related factors were associated with cannula position. Placement of the cannula deep in the inferior vena cava was associated with reduced venous return and may be a more important cause of reduced return than a cannula positioned in a hepatic vein.Correct positioning of the venous cannula draining blood to the cardiopulmonary bypass circuit is important. Intraoperative transesophageal echocardiography allows satisfactory determination of the cannula position in nearly all patients. Ten percent of venous cannulae are primarily positioned in the right hepatic vein and not in the inferior vena cava as intended. |
| Databáze: | OpenAIRE |
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