Key result
TEE visualizes acute venous cannula obstruction by clots during CPB, guiding prompt surgical evacuation.
Why the study?
Acute disruption of venous return during cardiopulmonary bypass can be caused by various mechanical factors including venous cannula obstruction, but visualization and diagnosis methods during CPB are not well described.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Intraoperative TEE is a valuable tool for rapidly diagnosing the cause of acute venous inflow cessation, such as cannula obstruction by migrating blood clots, during cardiopulmonary bypass.
Acute disruption of venous return during cardiopulmonary bypass (CPB) may be due to malposition of the venous cannula, kinks or obstruction of the venous tubing by a smaller cannula, airlock, or mechanical disruption of blood flow. We describe an acute obstruction of the venous cannula by blood clots that were visualized on the transesophageal echocardiogram during CPB. Appropriate measures were taken by the surgeon to evacuate the clot and restore CPB. The clots were not seen on the transesophageal echocardiogram before CPB raising suspicion that they originated in a lower extremity and migrated to the right atrium resulting in venous cannula obstruction.
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Fierro et al. (2014) conducted a case report in Acute obstruction of venous cannula during cardiopulmonary bypass (n=1). Transesophageal echocardiography was evaluated on Visualization of blood clots obstructing the venous cannula. Transesophageal echocardiography successfully visualized an acute obstruction of the venous cannula by blood clots during cardiopulmonary bypass, allowing for prompt surgical evacuation.
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