[ASSESSMENT OF LIVER FUNCTION WITH TRANSESOPHAGEAL ECHOCARDIOGRAPHY HEART SURGERY WITH CARDIOPULMONARY BYPASS]

Area of Science:

• Cardiovascular Surgery
• Hepatology
• Medical Imaging

Background:

• Cardiopulmonary bypass (CPB) is critical for cardiac surgery but can impact organ perfusion.
• Transesophageal echocardiography (TEE) offers a non-invasive method to assess hemodynamic changes.
• Liver function is sensitive to circulatory alterations during CPB.

Purpose of the Study:

• To evaluate arterial and venous liver circulation during CPB using TEE.
• To correlate hepatic blood flow with biochemical markers of liver function.
• To assess the utility of dynamic hepatic circulation monitoring for early diagnosis of liver dysfunction.

Main Methods:

• Sixty-two patients undergoing cardiac surgery with CPB were analyzed.
• Transesophageal echocardiography (TEE) with Doppler was used to measure hepatic artery and vein blood flow.
• Mean arterial pressure, heart rate, central venous pressure, and liver biochemical markers (lactate, AST/ALT ratio) were monitored throughout CPB and postoperatively.

Main Results:

• A correlation was observed between hepatic blood flow dynamics and biochemical analysis.
• Reduced blood flow in hepatic vessels during CPB was associated with early signs of liver insufficiency.
• These circulatory changes are considered a potential factor requiring correction during the perioperative period.

Conclusions:

• Dynamic monitoring of hepatic circulation via TEE can serve as an early diagnostic tool for functional liver disorders.
• Identifying reduced hepatic blood flow during CPB is crucial for timely intervention.
• TEE assessment of liver hemodynamics aids in managing patients undergoing CPB.