TEE for Lung Transplantation: A Case Series and Discussion of Vascular Complications

Abstract

Summary Stenosis at either the pulmonary artery (PA) or pulmonary vein (PV) anastomosis during lung transplantation (LTx) is a serious complication that requires an accurate and timely diagnosis for optimal clinical management. Transesophageal echocardiography (TEE) can play an essential role in making these diagnoses, both intraoperatively and postoperatively. However, it is important to recognize the limitations of TEE in this setting, including the lack of official guidelines to diagnose PA or PV stenosis. In this series, we describe four cases of vascular complications associated with LTx. We highlight the utility of TEE in the perioperative management of these patients, and discuss the diagnostic considerations when using this tool to assess the PA and PV anastomoses. As experts in perioperative echocardiography, anesthesiologists can employ TEE to enhance surgical success and improve patient outcomes after LTx. We therefore advocate the use of TEE during all cases of LTx, and encourage further efforts into the development of official echocardiographic guidelines specific to this patient population.