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Cardiology Research and Practice
Volume 2012, Article ID 723418, 6 pages
http://dx.doi.org/10.1155/2012/723418
Clinical Study

Transoesophageal Echocardiography for Monitoring Liver Surgery: Data from a Pilot Study

1Anesthesiology Department, Hospital Curry Cabral, Rua da Beneficência 8, 1069-166 Lisbon, Portugal
2CEDOC, Faculdade de Ciências Médicas, Lisbon, Portugal

Received 24 April 2011; Revised 18 December 2011; Accepted 14 February 2012

Academic Editor: Antoine Vieillard-Baron

Copyright © 2012 Filipe Pissarra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A pilot study aimed to introduce intraoperative monitoring of liver surgery using transoesophageal echocardiography (TEE) is described. A set of TEE measurements was established as a protocol, consisting of left atrial (LA) dimension at the aortic valve plane; mitral velocity flow integral, calculation of stroke volume and cardiac output (CO); mitral annular plane systolic excursion; finally, right atrial area. A total of 165 measurements (on 21 patients) were performed, 31 occurring during hypotension. The conclusions reached were during acute blood loss LA dimension changed earlier than CVP, and, in one patient, a dynamic left ventricular (LV) obstruction was observed; in 3 patients a transient LV systolic dysfunction was documented. The comparison between 39 CO paired measurements obtained by TEE and PiCCO2 revealed a statistically significant correlation ( , ). In this pilot study TEE successfully answered the questions raised by the anesthesiologists. Larger cohort studies are needed to address this issue.