ArticleJA clinical reports2025
Intraoperative transesophageal echocardiography under aortic arch branch blood flow monitoring in a patient with an aberrant left subclavian artery: a case report.
Article in JA clinical reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
backgroundTransesophageal echocardiography (TEE) is widely used in cardiac and non-cardiac surgeries with major hemodynamic fluctuations. In patients with vascular anomalies near the esophagus, such as an aberrant left subclavian artery (ALSA), TEE may pose a risk of vascular compression. However, no guidelines exist. CASE PRESENTATION: A 19-year-old woman with biliary atresia underwent living donor liver transplantation. Preoperative imaging showed a right-sided aortic arch with ALSA coursing posterior to the esophagus, and ALSA compression was considered a risk during TEE. Therefore, bilateral radial arterial pressures and regional cerebral oxygen saturation (rSO₂) were monitored. The TEE probe was inserted under videolaryngoscopic guidance without resistance or hemodynamic disturbance, and no arterial waveform attenuation or rSO₂ changes occurred. Transplantation was uneventful, and the patient showed no postoperative neurological or upper-limb deficits.
conclusionThis case highlights that appropriate imaging and monitoring strategies can support safe TEE use in non-cardiac surgery, even with vascular anomalies.
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