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This case demonstrates how Transit Time Flow Measurement (TTFM) can be used during liver transplant surgery to detect technical errors.
Liver Tx: Compromised anastomosis detected with TTFM
Intraoperative completion control with TTFM
TTFM was performed in the hepatic artery after completing an end-to-end anastomosis.
TTFM probes from the PV series were used during this surgery as seen in Image 1. Notice how the slider keeps the vessel in place so the readings can be as accurate as possible.
The first measurement showed low flow of 66 mL/min with a jagged flow curve, indicating that the anastomosis could be compromised (Image 2).
After revision of the anastomosis, TTFM in the hepatic artery improved to 248 mL/min with a pulsatile flow curve (Image 3).
This case confirms that TTFM plays a significant role in detecting compromised anastomosis or other technical errors during liver transplant surgery reducing the risk for postoperative complications.
Case attachments
Click images below to view.
Placing PV probe with slider on the hepatic artery
Initial TTFM with low flow and jagged flow curve
TTFM remeasured post revision showing adequate flow
Technology used
Medistim MiraQTM Vascular System with Vascular TTFM Probes (PV series).
