Can Coronary Vein Size Predict Hemodynamic Instability During Inferior Vena Cava Clamping in Liver Transplantation?

• Published in: Transplantation proceedings 2014-04, Vol.46 (3), p.692-695
• Main Authors: Huang, C.-E, Yang, S.-C, Chen, C.-L, Cheng, Y.-F, Cheng, K.-W, Wang, C.-H, Wu, S.-C, Huang, C.-J, Jawan, B, Shih, T.-H
• Format: Article
• Language: English
• Subjects: Coronary Vessels - anatomy & histology; Hemodynamics; Humans; Liver Transplantation; Surgery; Vena Cava, Inferior - surgery
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2013.11.024

Abstract Objective This study aimed to determine whether coronary vein size can serve as a predictor of hemodynamic instability during inferior vena cava clamping in living-donor liver transplantations. Methods Fifty-two patients' hemodynamic data before and after clamping were retrospectively analyzed and compared with the use of linear regression and repeated measurement. Data included arterial blood pressure, heart rate, central venous pressure, cardiac output, cardiac index, stroke volume, stroke volume variation, and systemic vascular resistance. Results The values of hemodynamic parameters at 1, 3, 10, and 30 minutes after clamping were compared with baseline data. All changes were found to be significant when the presence of the coronary vein was not considered. When the coronary vein was taken into consideration, linear regression analysis showed that only the percentage changes of cardiac index; stroke volume at 1, 3, and 10 minutes; and systemic vascular resistance at 1 minute after portal and inferior vena cava clamping were significantly correlated with the presence of the coronary vein. Conclusions Coronary vein size is a weak predictor of hemodynamic tolerability and instability during portal vein and inferior vena cava clamping in this kind of surgery.