title: Transesophageal and contact ultrasound echographic assessments of pulmonary vessels in bilateral lung transplantation.
abstract: BACKGROUND
  Intraoperative transesophageal echocardiographic visualization of the vascular anastomosis of lung grafts can be difficult. The goal of this prospective study was to compare intraoperative transesophageal echocardiography and contact ultrasound.
  
  
  METHODS
  Vessel imaging and Doppler analysis obtained before chest closure by both techniques were compared in 18 bilateral lung transplant recipients.
  
  
  RESULTS
  Twenty-four arteries in 36 and 45 pulmonary veins in 72 were recorded using transesophageal echocardiography versus 34 and 60 by contact ultrasound (p = 0.05). Views of the left pulmonary artery (p = 0.04) and of the left superior and inferior pulmonary veins (p = 0.04 and p = 0.02, respectively) were more often obtained with contact ultrasound. Measurements of vessel diameters were similar by both methods except for the left superior vein, which was smaller by the transesophageal approach (p = 0.002). In 1 patient, inferior venous diameters could not be obtained by either method. Nine arterial and 47 venous velocities were recorded by transesophageal echocardiography versus 21 and 33 by contact ultrasound (p = 0.001). Contact ultrasound produced better left pulmonary artery recordings (p = 0.02), whereas transesophageal echocardiography was more effective on venous velocities. Left inferior vein velocity was twofold higher using transesophageal echocardiography (p < 0.001).
  
  
  CONCLUSIONS
  These results suggest clinicians should exercise caution when making treatment decisions when using transesophageal echocardiography alone.
authors.affiliation: Department of Anesthesiology, Foch Hospital, Suresnes, France.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Felten
authors.forename: Mireille
authors.initials: M
authors.lastname: Michel-Cherqui
authors.forename: Edouard
authors.initials: E
authors.lastname: Sage
authors.forename: Marc
authors.initials: M
authors.lastname: Fischler
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D016040:Lung Transplantation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult