Imaging of pulmonary artery and vein anastomoses by transesophageal echocardiography after lung transplantation.

Abstract

In patients after isolated lung transplantation, the postoperative course may be complicated by dysfunction of the pulmonary artery and vein anastomoses. Pulmonary artery and vein anastomoses in 11 transplanted lungs (four left, four right, and three bilateral lungs) in 10 patients were studied 1 day to 11 months after operation by transesophageal echocardiography (TEE). All 14 pulmonary vein anastomoses, all seven right (100%) and five of seven (71%) left pulmonary artery anastomoses could be visualized by TEE. Thrombosis of a left pulmonary vein anastomosis could be identified by TEE and successfully treated by thrombolysis. TEE detected a significant stenosis in one right and one left pulmonary artery anastomosis; anastomoses dysfunction were confirmed by cardiac catheterization and pulmonary angiography and successfully treated by surgical correction in both cases. Function and morphology of pulmonary artery and vein anastomoses in patients after isolated lung transplantation can reliably be assessed by TEE. In patients with suspected dysfunction of an anastomosis, TEE may be considered the diagnostic technique of choice.