{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:15:30Z","timestamp":1778865330963,"version":"3.51.4"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transesophageal echocardiography (TEE) is widely used in cardiac and non-cardiac surgeries with major hemodynamic fluctuations. In patients with vascular anomalies near the esophagus, such as an aberrant left subclavian artery (ALSA), TEE may pose a risk of vascular compression. However, no guidelines exist.<\/jats:p>\n                    <jats:p>Case presentation.<\/jats:p>\n                    <jats:p>A 19-year-old woman with biliary atresia underwent living donor liver transplantation. Preoperative imaging showed a right-sided aortic arch with ALSA coursing posterior to the esophagus, and ALSA compression was considered a risk during TEE. Therefore, bilateral radial arterial pressures and regional cerebral oxygen saturation (rSO\u2082) were monitored. The TEE probe was inserted under videolaryngoscopic guidance without resistance or hemodynamic disturbance, and no arterial waveform attenuation or rSO\u2082 changes occurred. Transplantation was uneventful, and the patient showed no postoperative neurological or upper-limb deficits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights that appropriate imaging and monitoring strategies can support safe TEE use in non-cardiac surgery, even with vascular anomalies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40981-025-00828-2","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T10:10:05Z","timestamp":1762164605000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intraoperative transesophageal echocardiography under aortic arch branch blood flow monitoring in a patient with an aberrant left subclavian artery: a case report"],"prefix":"10.1186","volume":"11","author":[{"given":"Yasutaka","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8048-7810","authenticated-orcid":false,"given":"Takahiro","family":"Kawaji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidefumi","family":"Komura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Komatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohide","family":"Kuriyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"828_CR1","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.echo.2020.08.020","volume":"33","author":"A Nicoara","year":"2020","unstructured":"Nicoara A, Skubas N, Ad N, et al. Guidelines for the use of transesophageal echocardiography to assist with surgical decision-making in the operating room: a surgery-based approach: from the American society of echocardiography in collaboration with the society of cardiovascular anesthesiologists and the society of thoracic surgeons. J Am Soc Echocardiogr. 2020;33:692\u2013734. https:\/\/doi.org\/10.1016\/j.echo.2020.08.020.","journal-title":"J Am Soc Echocardiogr"},{"key":"828_CR2","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s12630-017-1017-7","volume":"65","author":"A Fayad","year":"2018","unstructured":"Fayad A, Shillcutt SK. Perioperative transesophageal echocardiography for non-cardiac surgery. Can J Anaesth. 2018;65:381\u201398. https:\/\/doi.org\/10.1007\/s12630-017-1017-7.","journal-title":"Can J Anaesth"},{"key":"828_CR3","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/j.echo.2010.08.013","volume":"23","author":"JN Hilberath","year":"2010","unstructured":"Hilberath JN, Oakes DA, Shernan SK, et al. Safety of transesophageal echocardiography. J Am Soc Echocardiogr. 2010;23:1115\u201327. https:\/\/doi.org\/10.1016\/j.echo.2010.08.013.","journal-title":"J Am Soc Echocardiogr"},{"key":"828_CR4","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1016\/s0894-7317(05)80028-8","volume":"8","author":"AS Bensky","year":"1995","unstructured":"Bensky AS, O\u2019Brien JJ, Hammon JW. Transesophageal echo probe compression of an aberrant right subclavian artery. J Am Soc Echocardiogr. 1995;8:964\u20136. https:\/\/doi.org\/10.1016\/s0894-7317(05)80028-8.","journal-title":"J Am Soc Echocardiogr"},{"key":"828_CR5","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1046\/j.1460-9592.2003.00958.x","volume":"13","author":"H Koinig","year":"2003","unstructured":"Koinig H, Schlemmer M, Keznickl FP. Occlusion of the right subclavian artery after insertion of a transoesophageal echocardiography probe in a neonate. Paediatr Anaesth. 2003;13:617\u20139. https:\/\/doi.org\/10.1046\/j.1460-9592.2003.00958.x.","journal-title":"Paediatr Anaesth"},{"key":"828_CR6","doi-asserted-by":"publisher","first-page":"283","DOI":"10.4097\/kjae.2010.59.4.283","volume":"59","author":"SY Park","year":"2010","unstructured":"Park SY, Kim DH, Joe HB, et al. Occlusion of the right subclavian artery after insertion of a transesophageal echocardiography probe in an adult with a vascular ring -a case report-. Korean J Anesthesiol. 2010;59:283\u20135. https:\/\/doi.org\/10.4097\/kjae.2010.59.4.283.","journal-title":"Korean J Anesthesiol"},{"key":"828_CR7","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1053\/j.jvca.2009.12.013","volume":"25","author":"RL Sierra","year":"2011","unstructured":"Sierra RL, Lee E, Pilla M. Aberrant right subclavian artery occlusion from insertion of a transesophageal echocardiographic probe in an asymptomatic adult. J Cardiothorac Vasc Anesth. 2011;25:148\u20139. https:\/\/doi.org\/10.1053\/j.jvca.2009.12.013.","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"828_CR8","doi-asserted-by":"publisher","first-page":"233","DOI":"10.4103\/0971-9784.97980","volume":"15","author":"V Garg","year":"2012","unstructured":"Garg V, Joshi R, Joshi R. Compression of undiagnosed aberrant right subclavian artery during transesophageal echocardiography probe insertion. Ann Card Anaesth. 2012;15:233\u20135. https:\/\/doi.org\/10.4103\/0971-9784.97980.","journal-title":"Ann Card Anaesth"},{"key":"828_CR9","unstructured":"Lee WI, Kim DH, Chae YJ, et al. Compression of the left subclavian artery caused by a transesophageal echocardiography probe in an infant with a right-sided aortic arch: a case report. Anesth Pain Med. 2013;8:196\u2013198. https:\/\/www.anesth-pain-med.org\/upload\/pdf\/Apm008-03-11.pdf."},{"key":"828_CR10","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jclinane.2015.06.016","volume":"28","author":"K Hattori","year":"2016","unstructured":"Hattori K, Komasawa N, Kuzukawa Y, et al. Right radial artery pulse loss after transesophageal echocardiography probe insertion in an infant with an aberrant right subclavian artery. J Clin Anesth. 2016;28:84. https:\/\/doi.org\/10.1016\/j.jclinane.2015.06.016.","journal-title":"J Clin Anesth"},{"key":"828_CR11","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.case.2020.07.003","volume":"4","author":"DA Apatov","year":"2020","unstructured":"Apatov DA, Spellman JL, Takayama H, et al. An unrecognized contraindication to transesophageal echocardiographic probe placement: the aberrant right subclavian artery. Case. 2020;4:448\u201351. https:\/\/doi.org\/10.1016\/j.case.2020.07.003.","journal-title":"Case"},{"key":"828_CR12","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1007\/s00276-002-0047-0","volume":"24","author":"V Almenar-Garc\u00eda","year":"2002","unstructured":"Almenar-Garc\u00eda V, Terol FF, Correa-Lacarcel J, et al. Retro-esophageal subclavian artery: a case report. Surg Radiol Anat. 2002;24:231\u20134. https:\/\/doi.org\/10.1007\/s00276-002-0047-0.","journal-title":"Surg Radiol Anat"},{"key":"828_CR13","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1136\/hrt.28.6.722","volume":"28","author":"AR Hastreiter","year":"1966","unstructured":"Hastreiter AR, D\u2019Cruz IA, Cantez T, et al. Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies. Br Heart J. 1966;28:722\u201339. https:\/\/doi.org\/10.1136\/hrt.28.6.722.","journal-title":"Br Heart J"},{"key":"828_CR14","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1016\/j.jvs.2020.10.063","volume":"73","author":"AA Khan","year":"2021","unstructured":"Khan AA, Patel J, Desikan S, et al. Asymptomatic carotid artery stenosis is associated with cerebral hypoperfusion. J Vasc Surg. 2021;73:1611-1621.e2. https:\/\/doi.org\/10.1016\/j.jvs.2020.10.063.","journal-title":"J Vasc Surg"},{"key":"828_CR15","first-page":"51","volume":"10","author":"K Kochi","year":"2004","unstructured":"Kochi K, Sueda T. Inflammatory aortic arch aneurysm with total occlusion of cervical branches. Ann Thorac Cardiovasc Surg. 2004;10:51\u20133.","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"828_CR16","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3389\/fphys.2014.00093","volume":"5","author":"HB Nielsen","year":"2014","unstructured":"Nielsen HB. Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery. Front Physiol. 2014;5:93. https:\/\/doi.org\/10.3389\/fphys.2014.00093.","journal-title":"Front Physiol"},{"key":"828_CR17","doi-asserted-by":"publisher","first-page":"2432","DOI":"10.4254\/wjh.v7.i23.2432","volume":"7","author":"L De Pietri","year":"2015","unstructured":"De Pietri L, Mocchegiani F, Leuzzi C, et al. Transoesophageal echocardiography during liver transplantation. World J Hepatol. 2015;7:2432\u201348. https:\/\/doi.org\/10.4254\/wjh.v7.i23.2432.","journal-title":"World J Hepatol"},{"key":"828_CR18","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1002\/lt.25800","volume":"26","author":"L De Marchi","year":"2020","unstructured":"De Marchi L, Wang CJ, Skubas NJ, et al. Safety and benefit of transesophageal echocardiography in liver transplant surgery: a position paper from the Society for the Advancement of Transplant Anesthesia (SATA). Liver Transpl. 2020;26:1019\u201329. https:\/\/doi.org\/10.1002\/lt.25800.","journal-title":"Liver Transpl"},{"key":"828_CR19","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s40981-023-00646-4","volume":"9","author":"Y Ueda","year":"2023","unstructured":"Ueda Y, Kawaji T, Komura H, et al. Usefulness of intraoperative transesophageal echocardiography for hemodynamic management of liver transplantation in a patient with massive polycystic liver disease: a case report. JA Clin Rep. 2023;9:54. https:\/\/doi.org\/10.1186\/s40981-023-00646-4.","journal-title":"JA Clin Rep"},{"key":"828_CR20","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1053\/j.jvca.2019.02.050","volume":"34","author":"MW Manning","year":"2020","unstructured":"Manning MW, Kumar PA, Maheshwari K, et al. Post-reperfusion syndrome in liver transplantation-an overview. J Cardiothorac Vasc Anesth. 2020;34:501\u201311. https:\/\/doi.org\/10.1053\/j.jvca.2019.02.050.","journal-title":"J Cardiothorac Vasc Anesth"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00828-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-025-00828-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00828-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T10:10:07Z","timestamp":1762164607000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-025-00828-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,3]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["828"],"URL":"https:\/\/doi.org\/10.1186\/s40981-025-00828-2","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,3]]},"assertion":[{"value":"27 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this case report and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"64"}}