title: Intraoperative intracardiac thrombosis in a liver transplant patient.
abstract: A 66-year-old female with cryptogenic cirrhosis complicated by ascites, hepatic encephalopathy, variceal bleeding and malnutrition with MELD of 34 underwent orthotopic deceased donor liver transplantation performed with piggyback technique. Extensive eversion thromboendovenectomy was performed for a portal vein thrombus which resulted in an excellent portal vein flow. The liver graft was recirculated without any hemodynamic instability. Subsequently, the patient became hypotensive progressing to asystole. She was resuscitated and a transesophageal probe was inserted which revealed a mobile right atrial thrombus and an underfilled poorly contractile right ventricle. The patient was noted to be coagulopathic at the time. She became progressively more stable with a TEE showing complete resolution of the intracardiac thrombus.
authors.affiliation: Lena Sibulesky, C Burcin Taner, Justin H Nguyen, Department of Transplantation, Division of Transplant Surgery, Mayo Clinic, Jacksonville, FL 32224, United States.
authors.forename: Lena
authors.initials: L
authors.lastname: Sibulesky
authors.forename: Prith
authors.initials: P
authors.lastname: Peiris
authors.forename: C Burcin
authors.initials: CB
authors.lastname: Taner
authors.forename: David J
authors.initials: DJ
authors.lastname: Kramer
authors.forename: Juan M
authors.initials: JM
authors.lastname: Canabal
authors.forename: Justin H
authors.initials: JH
authors.lastname: Nguyen