Transesophageal echocardiography in the management of left atrio-femoral bypass during thoracoabdominal aortic aneurysm repair: a case report

PurposeTo describe the utility of transesophageal echocardiography (TEE) in a patient undergoing thoracoabdominal aneurysm (TAA) surgery using left atrio-femoral bypass (LAFB).Clinical featuresA 57-yr-old female patient underwent repair of type II TAA, As per institutional routine, LAFB technique was used. Initial difficulty with the pump flow was encountered, TEE images showed that the left atrial cannula was positioned against the left atrial wall. The cannula position was adjusted and the pump flow was established. During different stages of the surgery, TEE was used to monitor the left ventricular cavity size and its function. This allowed the adjustment of LAFB pump flow relative to left ventricular filling and optimal fluid resuscitation in order to maintain both upper and lower body perfusion.ConclusionIn this patient, TEE was useful to confirm the correct position of the left atrial cannula and for hemodynamic management during LAFB.