Use of multi-plane transoesophageal echocardiography in visualization of the main hepatic veins and acquisition of Doppler sonography curves. Comparison with the transabdominal approach.

The role of multi-plane transoesophageal echocardiography (TOE) in the visualization of the three main hepatic veins and acquisition of Doppler sonography curves has not been established. We have studied this diagnostic option of TOE in 34 patients during general anaesthesia. The findings were compared with the results of conventional transabdominal sonography (TAS). Using TOE, each of the three main hepatic veins could be visualized in all patients. In contrast, TAS allowed adequate two-dimensional visualization of the right, middle, and left hepatic vein in only 97%, 85%, and 61% of the patients, respectively. Adequate Doppler tracings of the right and middle hepatic vein could be obtained in 100% and 97% of the patients by TOE and in 91% and 50% of the patients by TAS. Doppler tracings of the left hepatic vein could only be acquired in 18% of the patients by TOE, but in 47% of the patients by TAS. As blood flow may be calculated from the diameter of the vessel, velocity time integral of the Doppler curve and heart rate, TOE may provide an interesting non-invasive tool to monitor blood flow in the right and middle hepatic vein.