{"id":"https://openalex.org/W7225419015","doi":"https://doi.org/10.1186/s12871-026-04416-4","title":"Position-dependent unilateral pseudohypotension during transesophageal echocardiography in a patient with a retroesophageal aberrant right subclavian artery undergoing transcatheter aortic valve replacement: a case report","display_name":"Position-dependent unilateral pseudohypotension during transesophageal echocardiography in a patient with a retroesophageal aberrant right subclavian artery undergoing transcatheter aortic valve replacement: a case report","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225419015","doi":"https://doi.org/10.1186/s12871-026-04416-4"},"language":"en","primary_location":{"id":"doi:10.1186/s12871-026-04416-4","doi":"https://doi.org/10.1186/s12871-026-04416-4","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12871-026-04416-4","pdf_url":null,"source":{"id":"https://openalex.org/S197988427","display_name":"BMC Anesthesiology","issn_l":"1471-2253","issn":["1471-2253"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Anesthesiology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12871-026-04416-4","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161080604","display_name":"Fei Ge","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802390878","display_name":"Sir Run Run Shaw Hospital","ror":"https://ror.org/00ka6rp58","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I2802390878"]},{"id":"https://openalex.org/I76130692","display_name":"Zhejiang University","ror":"https://ror.org/00a2xv884","country_code":"CN","type":"education","lineage":["https://openalex.org/I76130692"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Fei Ge","raw_affiliation_strings":["Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Shangcheng District, Hangzhou, 310016, Zhejiang, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 East Qingchun Road, Shangcheng District, Hangzhou, 310016, Zhejiang, China","institution_ids":["https://openalex.org/I2802390878","https://openalex.org/I76130692"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161141406","display_name":"Weiqiao Zhang","orcid":"https://orcid.org/0009-0007-6551-5506","observed_orcids":["https://orcid.org/0009-0007-6551-5506"]},"institutions":[{"id":"https://openalex.org/I114539943","display_name":"Zhejiang Chinese Medical University","ror":"https://ror.org/04epb4p87","country_code":"CN","type":"education","lineage":["https://openalex.org/I114539943"]},{"id":"https://openalex.org/I4210095527","display_name":"Zhejiang Provincial Hospital of TCM","ror":"https://ror.org/00mzdyq43","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210095527"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Weiqiao Zhang","raw_affiliation_strings":["Department of Anesthesiology, The First Affiliated Hospital of Zhejiang, Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Shangcheng District, Hangzhou, 310006, Zhejiang, China"],"raw_orcid":"https://orcid.org/0009-0007-6551-5506","affiliations":[{"raw_affiliation_string":"Department of Anesthesiology, The First Affiliated Hospital of Zhejiang, Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Shangcheng District, Hangzhou, 310006, Zhejiang, China","institution_ids":["https://openalex.org/I114539943","https://openalex.org/I4210095527"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5161141406"],"corresponding_institution_ids":["https://openalex.org/I114539943","https://openalex.org/I4210095527"],"apc_list":{"value":3190,"currency":"USD","value_usd":3190},"apc_paid":{"value":3190,"currency":"USD","value_usd":3190},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12342","display_name":"Vascular anomalies and interventions","score":0.29490000009536743,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12342","display_name":"Vascular anomalies and interventions","score":0.29490000009536743,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10300","display_name":"Congenital Heart Disease Studies","score":0.15539999306201935,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10172","display_name":"Cardiac Valve Diseases and Treatments","score":0.13050000369548798,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/transesophageal-echocardiography","display_name":"transesophageal echocardiography","score":0.8769999742507935},{"id":"https://openalex.org/keywords/aberrant-right-subclavian-artery","display_name":"aberrant right subclavian artery","score":0.8640000224113464},{"id":"https://openalex.org/keywords/retroesophageal-subclavian-artery","display_name":"retroesophageal subclavian artery","score":0.7649999856948853},{"id":"https://openalex.org/keywords/transcatheter-aortic-valve-replacement","display_name":"transcatheter aortic valve implantation","score":0.8519999980926514},{"id":"https://openalex.org/keywords/aortic-stenosis","display_name":"aortic stenosis","score":0.8519999980926514},{"id":"https://openalex.org/keywords/metaraminol","display_name":"metaraminol","score":0.640999972820282}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9526000022888184},{"id":"https://openalex.org/C2778218979","wikidata":"https://www.wikidata.org/wiki/Q662857","display_name":"Radial artery","level":3,"score":0.6021000146865845},{"id":"https://openalex.org/C2780007028","wikidata":"https://www.wikidata.org/wiki/Q2343082","display_name":"Stenosis","level":2,"score":0.475600004196167},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.4715999960899353},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.4350999891757965},{"id":"https://openalex.org/C2779980429","wikidata":"https://www.wikidata.org/wiki/Q101004","display_name":"Aorta","level":2,"score":0.4052000045776367},{"id":"https://openalex.org/C2779723990","wikidata":"https://www.wikidata.org/wiki/Q707174","display_name":"Femoral artery","level":2,"score":0.39469999074935913},{"id":"https://openalex.org/C2780643987","wikidata":"https://www.wikidata.org/wiki/Q468414","display_name":"Angiography","level":2,"score":0.36890000104904175},{"id":"https://openalex.org/C2781427539","wikidata":"https://www.wikidata.org/wiki/Q515917","display_name":"Brachiocephalic artery","level":4,"score":0.3540000021457672},{"id":"https://openalex.org/C2781347138","wikidata":"https://www.wikidata.org/wiki/Q1024492","display_name":"Computed tomography angiography","level":3,"score":0.34619998931884766},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.34450000524520874},{"id":"https://openalex.org/C2780017030","wikidata":"https://www.wikidata.org/wiki/Q368366","display_name":"Cuff","level":2,"score":0.3384000062942505},{"id":"https://openalex.org/C2780663194","wikidata":"https://www.wikidata.org/wiki/Q3270170","display_name":"Descending aorta","level":3,"score":0.33649998903274536},{"id":"https://openalex.org/C2777385415","wikidata":"https://www.wikidata.org/wiki/Q1615191","display_name":"Cardiac catheterization","level":2,"score":0.3215999901294708},{"id":"https://openalex.org/C2781414266","wikidata":"https://www.wikidata.org/wiki/Q531019","display_name":"Aortic valve stenosis","level":3,"score":0.3174000084400177},{"id":"https://openalex.org/C84393581","wikidata":"https://www.wikidata.org/wiki/Q82642","display_name":"Blood pressure","level":2,"score":0.3172999918460846},{"id":"https://openalex.org/C2779684181","wikidata":"https://www.wikidata.org/wiki/Q502164","display_name":"Axillary artery","level":2,"score":0.3167000114917755},{"id":"https://openalex.org/C2777055891","wikidata":"https://www.wikidata.org/wiki/Q185325","display_name":"Cardiopulmonary resuscitation","level":3,"score":0.3163999915122986},{"id":"https://openalex.org/C2780714102","wikidata":"https://www.wikidata.org/wiki/Q616071","display_name":"Aortic valve","level":2,"score":0.3061999976634979},{"id":"https://openalex.org/C2780026749","wikidata":"https://www.wikidata.org/wiki/Q7912830","display_name":"Valve replacement","level":3,"score":0.3018999993801117},{"id":"https://openalex.org/C2781072225","wikidata":"https://www.wikidata.org/wiki/Q490059","display_name":"Subclavian artery","level":2,"score":0.30149999260902405},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.29809999465942383},{"id":"https://openalex.org/C79191276","wikidata":"https://www.wikidata.org/wiki/Q7259620","display_name":"Pulsatile flow","level":2,"score":0.27140000462532043},{"id":"https://openalex.org/C2778249958","wikidata":"https://www.wikidata.org/wiki/Q2349469","display_name":"Ascending aorta","level":3,"score":0.2696000039577484},{"id":"https://openalex.org/C2778074680","wikidata":"https://www.wikidata.org/wiki/Q2125439","display_name":"Cannula","level":2,"score":0.2662000060081482},{"id":"https://openalex.org/C2778119558","wikidata":"https://www.wikidata.org/wiki/Q4778773","display_name":"Aortography","level":3,"score":0.2653000056743622},{"id":"https://openalex.org/C541997718","wikidata":"https://www.wikidata.org/wiki/Q188151","display_name":"Ischemia","level":2,"score":0.26429998874664307},{"id":"https://openalex.org/C2781064879","wikidata":"https://www.wikidata.org/wiki/Q214275","display_name":"Common carotid artery","level":3,"score":0.26100000739097595},{"id":"https://openalex.org/C2777521253","wikidata":"https://www.wikidata.org/wiki/Q770709","display_name":"Blunt trauma","level":2,"score":0.25870001316070557},{"id":"https://openalex.org/C39124391","wikidata":"https://www.wikidata.org/wiki/Q4778759","display_name":"Aortic pressure","level":3,"score":0.25839999318122864},{"id":"https://openalex.org/C2781068581","wikidata":"https://www.wikidata.org/wiki/Q5045544","display_name":"Carotid endarterectomy","level":3,"score":0.25839999318122864},{"id":"https://openalex.org/C2779578232","wikidata":"https://www.wikidata.org/wiki/Q1757897","display_name":"Cricoid pressure","level":3,"score":0.25619998574256897},{"id":"https://openalex.org/C2781285907","wikidata":"https://www.wikidata.org/wiki/Q616032","display_name":"Aortic arch","level":3,"score":0.25440001487731934},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.2506999969482422}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12871-026-04416-4","doi":"https://doi.org/10.1186/s12871-026-04416-4","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12871-026-04416-4","pdf_url":null,"source":{"id":"https://openalex.org/S197988427","display_name":"BMC Anesthesiology","issn_l":"1471-2253","issn":["1471-2253"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Anesthesiology","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12871-026-04416-4","doi":"https://doi.org/10.1186/s12871-026-04416-4","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12871-026-04416-4","pdf_url":null,"source":{"id":"https://openalex.org/S197988427","display_name":"BMC Anesthesiology","issn_l":"1471-2253","issn":["1471-2253"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Anesthesiology","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9763000011444092,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2025500063","https://openalex.org/W2199374210","https://openalex.org/W3047398888","https://openalex.org/W7163374895","https://openalex.org/W2111690180","https://openalex.org/W4415789915","https://openalex.org/W1990112246","https://openalex.org/W2914050914","https://openalex.org/W4255109970","https://openalex.org/W7130582022"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"An":[2],"isolated":[3],"fall":[4],"in":[5,15,264],"right":[6,21,88,234],"radial":[7,89,120,148,199,235],"pressure":[8,90,100,183,241,263],"during":[9,37,238,260],"transesophageal":[10],"echocardiography":[11],"(TEE)":[12],"can":[13,252],"occur":[14],"patients":[16],"with":[17,43,58,145,158,178],"a":[18,75,146,227],"retroesophageal":[19,76,228],"aberrant":[20],"subclavian":[22],"artery":[23],"(ARSA)":[24],"and":[25,49,104,106,113,150,169,204,257],"may":[26,268],"be":[27,231],"mistaken":[28],"for":[29],"systemic":[30],"hypotension.":[31],"We":[32],"report":[33],"such":[34],"an":[35,82],"event":[36],"transcatheter":[38],"aortic":[39,60],"valve":[40],"replacement":[41],"(TAVR),":[42],"continuous":[44,142],"documentation":[45],"of":[46,85,171,208,226,246,272],"probe":[47,126,152],"movement":[48],"arterial":[50,182,258],"waveform":[51,135,149,160],"changes.":[52,161,189],"Case":[53],"presentation":[54],"A":[55,140],"74-year-old":[56],"woman":[57],"critical":[59],"stenosis":[61],"underwent":[62],"transfemoral":[63],"TAVR":[64,201],"under":[65],"general":[66],"anesthesia.":[67],"Preprocedural":[68],"computed":[69],"tomography":[70],"angiography":[71],"(CTA)":[72],"had":[73],"shown":[74],"ARSA.":[77],"During":[78],"TEE":[79,191,239,255],"manipulation":[80],"at":[81],"estimated":[83],"depth":[84],"45\u201350":[86],"cm,":[87],"fell":[91],"from":[92],"136/63":[93],"to":[94,130,138,194],"approximately":[95],"47/42":[96],"mmHg.":[97],"Left-arm":[98],"cuff":[99],"was":[101,192,202,214],"94/54":[102],"mmHg,":[103],"carotid":[105],"femoral":[107],"pulses":[108],"remained":[109,184],"palpable.":[110],"Arterial-line":[111],"troubleshooting":[112],"intravenous":[114],"metaraminol":[115],"did":[116],"not":[117],"restore":[118],"the":[119,125,134,151,155,159,198],"waveform.":[121,200],"When":[122],"we":[123],"withdrew":[124],"toward":[127],"30":[128],"cm":[129],"reassess":[131],"cardiac":[132],"function,":[133],"unexpectedly":[136],"began":[137],"return.":[139],"later":[141],"recording":[143],"started":[144],"well-formed":[147],"deeper":[153],"than":[154],"segment":[156,166],"associated":[157],"Slow":[162],"withdrawal":[163],"through":[164],"this":[165],"produced":[167],"attenuation":[168],"loss":[170],"visible":[172],"pulsatility,":[173],"followed":[174],"by":[175],"its":[176],"return":[177],"further":[179],"withdrawal.":[180],"Femoral":[181],"119\u2013125/44":[185],"mmHg":[186],"throughout":[187],"these":[188],"Subsequent":[190],"limited":[193],"positions":[195],"that":[196],"preserved":[197],"completed,":[203],"no":[205],"clinical":[206],"evidence":[207],"right-arm":[209],"ischemia":[210],"or":[211],"esophageal":[212],"injury":[213],"documented":[215],"before":[216],"discharge":[217],"on":[218,249],"postoperative":[219],"day":[220],"8.":[221],"Conclusions":[222],"Possible":[223],"probe-related":[224],"compression":[225],"ARSA":[229],"should":[230],"considered":[232],"when":[233],"pulsatility":[236],"changes":[237],"while":[240],"elsewhere":[242],"remains":[243],"adequate.":[244],"Review":[245],"arch-vessel":[247],"anatomy":[248],"preprocedural":[250],"CTA":[251],"help":[253],"plan":[254],"use":[256],"monitoring":[259],"TAVR.":[261],"Comparing":[262],"another":[265],"vascular":[266],"territory":[267],"prevent":[269],"unnecessary":[270],"escalation":[271],"vasoactive":[273],"treatment.":[274]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-11-07T00:00:00"}