Transesophageal echocardiography-guided placement of internal jugular percutaneous venovenous bypass cannula in orthotopic liver transplantation

Venovenous bypass has improved patient survival and decreased morbidity and mortality in the field of orthotopic liver transplantation. The standard at many transplant centers is the use of the internal jugular percutaneous venovenous bypass cannulae (PVVBC) for venous return to the patient. Placement of these large (18F) PVVBC may lead to several complications and requires confirmation before use. Use of transesophageal echocardiography, an effective and rapid method to guide placement of the PVVBC and minimize potential complications associated with insertion of the device, is described.