Week 8 Part 2 Flashcards
For a liver transplant, where are the 4 vascular anastomoses?
suprahepatic vena cava infrahepatic VC hepatic artery portal vein *also biliary duct anastomosis
What’s the sequelae of events for anastomosis occlusions/stenosis:
necrosis-fibrosis-stenosis
What is the most significant vascular complication with liver transplant?
Hep artery thrombosis- high mortality rate
In assessing vascular patency in a liver transplant, what vessels are assessed? What are they inspected for?
HA, PV, IVC, HV’s
narrowed diameter, thrombus, normal spectral waveform + direction
If we’re going to see a renal artery thrombosis, when will we see it?
in the first few days
What’s the difference b/w primary and secondary renal vein thrombosis?
primary originates in the RV, secondary originates into iliac V
What renal artery is prone to stenosis? And where?
Rt main renal artery at the ostium (takeoff from aorta)
due to it’s sharp angle superiorly and then inferiorly towards the rt kidney
How do we obtain the AO/RA ratio
angle correct is used
PSV in AO just prox to RA takeoff
measure PSV within stenosis
RA PSV/ AO PSV
A AO/RA ratio of _____ is not considered to be hemodynamically significant
<3.5
PSV in the RA is considered normal up to what speed?
180cm/s
Distal RA there’s usually no window seen. True or false
True.
This was bolded in the slides
Replaced right hepatic artery originates from
SMA
Formula for resistive index?
PSV-EDV/PSV
What renal arteries do you want to obtain a signal in
arcuate or segmental at UP, mid and LP cortex.
she also said interlobar, interlobular, or segmental
What RI measurement indicates resistance?
> 0.7
What happens to the blood flow in the PV with inspiration and expiration?
decrease w/ inspiration (due to the inc abdo pressure)
increase w/ expiration (due to the dec abdo pressure)
What’s the normal size of the splenic vein?
<10mm
it increases in size w/ inspiration + portal hypertension
How do we measure an artery?
outer wall to outer wall
What’s the normal size of the SMV?
<10mm
will increase in size w/ inspiration, after a meal and portal hypertension
Increased flow velocity in the hepA is associated w/
jaundice, cirrhosis, lymphoma and mets
Normal flow velocity of the hepatic artery in a fasting patient?
PSV- 30-40cm/s
EDV- 10-15 cm/s
The splenic artery gives rise to what?
gastroepiploic
branches to the panc and stomach
What is a sign of IVC occlusion? What can cause it?
bilateral leg swelling
extrinsic compression -nodes
RCC
HCC
Right sided heart failure appears as what in the hep veins + IVC?
over distension bc of backup of flow
no phasic flow
IVC measures the same in inspiration and expiration
Budd Chiari syndrome is:
thrombus or hepatoma extension into HV’s
