BACKGROUND Pulmonary cuff dysfunction, either due to pulmonary vein obstruction, pulmonary vein stenosis , or pulmonary vein thrombosis, is an uncommon, yet serious complication after lung transplantation . Although there have been numerous reports of its occurrence, there is little consensus regarding the hemodynamic parameters associated with its presentation and diagnostic considerations. This systematic review summarizes the evidence surrounding pulmonary cuff dysfunction after lung transplantation surgery and empirically analyzes its implications. METHODS Databases were examined for all articles and abstracts reporting on pulmonary cuff dysfunction. Data collected included: number of patients studied; patients’ characteristics; incidences of pulmonary vein stenosis and pulmonary vein thrombosis; and timing and imaging modality utilized for diagnosis. RESULTS Thirty-four full-text citations were included in this review. The point prevalence of pulmonary vein stenosis and thrombosis were 1.4% and 2.5%, respectively. The peak pulmonary cuff velocity associated with dysfunction was found to be 1.59 ± 0.66 m/sec. The diameter of the dysfunctional pulmonary vein was noted to be 0.48 ± 0.20 cm. The majority of diagnoses were made in the early post-operative period using transesophageal echocardiography . Overall, 41.3% of patients (26 of 63) required emergent procedural reintervention, and 32% of patients (20 of 63) diagnosed with pulmonary cuff dysfunction died during their hospital stay. CONCLUSIONS This systematic review underscores the importance of identifying pulmonary cuff dysfunction after lung transplant surgery , and the usefulness of transesophageal echocardiography for detection of this complication. The clinical implications of these results warrant the further development of identification and management strategies for lung transplant patients.

Pulmonary cuff dysfunction after lung transplant surgery: A systematic review of the evidence and analysis of its clinical implications.

Transesophageal Echocardiography Monitoring During Lung Transplantation.

Multimodality Imaging to Diagnose Isolated Cardiac Sarcoidosis and Determine Regional Inflammatory Activity Levels.

Is it time to incorporate point-of-care ultrasound into the anesthesiology resident's training curriculum?

Restrictive cardiomyopathies (RCMs) are a diverse group of myocardial diseases with a wide range of aetiologies, including familial, genetic and acquired diseases and ranging from very rare to relatively frequent cardiac disorders. In all these diseases, imaging techniques play a central role. Advanced imaging techniques provide important novel data on the diagnostic and prognostic assessment of RCMs. This EACVI consensus document provides comprehensive information for the appropriateness of all non-invasive imaging techniques for the diagnosis, prognostic evaluation, and management of patients with RCM.

/pdf/multimodality-imaging-in-restrictive-cardiomyopathies-an-3sbm2lmb4r.pdf

Multimodality imaging in restrictive cardiomyopathies: an EACVI expert consensus document: In collaboration with the 'Working Group on myocardial and pericardial diseases' of the European Society of Cardiology Endorsed by the Indian Academy of Echocardiography

A 50-year-old female was admitted with a 2-year history of significant weight loss and a pyrexia of unknown origin. Hepatosplenomegaly and mildly enlarged retroperitoneal and mediastinal lymph nodes were seen on a computed tomography scan. The patient was profoundly cachectic with severe muscle wasting. Following an episode of acute pulmonary oedema, a transthoracic echocardiogram (TTE) was performed, revealing …

Non-tropical endomyocardial fibrosis associated with sarcoidosis

Background: Pulmonary vein stenosis or thrombosis (PVST) following lung transplantation is a rare but seriouscomplication thatmay lead tograft failure.Diagnosis is challenging, as its radiographical featuresmimic infection or other causes of pulmonary oedema. Transoesophageal echocardiography is often requested to evaluate anastamoses to exclude PVST, though reference ranges for normal Doppler flow in this setting are not widely known, and pulmonary vein velocities are often elevated in the immediate post-transplant period. Aims: To determine pulmonary vein Doppler flow ranges in patients not suspected to have PVST in the post transplant period. Methods: All lung transplants performed in the last six years were identified from a database. The pulmonary vein Doppler velocities were recorded from the left and the right pulmonary vein ‘buttons’. Clinical details were reviewed to determine if a clinical suspicion of PVS was present. Velocities recorded on the first transthoracic echocardiogram (TTE) or transoesophageal echocardiogram (TOE) post transplant were recorded. Results: There were a total of 108 patients (five single lung transplants, 103 double), with baseline characteristics age 44± 13years, 50/108 female. Velocities were able to be measured in 43 patients (17 TOE, 26TTE), a median of 11 days post transplant. Two patients were diagnosed with PVS (systolic/diastolic velocities 120/180 cm/s and 120/220 cm/s) and these values were excluded from calculations.

Echocardiographic Assessment of Pulmonary Vein Velocities Following Lung Transplantation

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Non-tropical endomyocardial fibrosis associated with sarcoidosis

Echocardiographic Assessment of Pulmonary Vein Velocities Following Lung Transplantation