Objective: To describe the experience regarding the perioperative management of patients with left ventricular assist devices (LVADs) who require anesthesia while undergoing noncardiac surgery (NCS) at a single medical center.

Design: Retrospective chart review

Setting: Academic medical center

Participants: Patients with LVADs

Interventions: Medical records from April 1, 2009 through January 31, 2014 were reviewed for patients who underwent Heartmate II LVAD placement at this facility. Individual records were reviewed for NCS after LVAD placement, specifically investigating perioperative and anesthetic management.

Measurements And Main Results: Seventy-one patients underwent LVAD placement during this time period. Thirty-five patients (49%) underwent a total of 101 NCS procedures. Arterial catheters were placed in 19 patients (19%), and 33 patients (33%) were intubated for their procedure. No complications or perioperative mortality occurred related to the NCS.

Conclusions: Noncardiac surgery is becoming more common in patients with LVADs. Anesthetic management of these patients outside of the cardiac operating room is limited. Patients with Heartmate II LVADs can safely undergo noncardiac surgery.

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jvca.2015.01.027DOI Listing

Publication Analysis

Top Keywords

noncardiac surgery
16
lvad placement
12
patients
11
management patients
8
patients underwent
8
management lvad
4
lvad patients
4
noncardiac
4
patients noncardiac
4
surgery
4

Similar Publications

Fast is fine, but accuracy is everything: making intraoperative transfusion decisions using point-of-care testing.

Br J Anaesth

February 2025

Transfusion Research Unit, Department of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia; Department of Clinical Haematology, Monash Health, Clayton, VIC, Australia.

Accurate and timely diagnostic information is a vital adjunct to clinical assessment to inform therapeutic decision-making, including decisions to transfuse, or not transfuse, blood components. A prospective cohort study of diagnostic point-of-care (POC) haemoglobin measurements on arterial or central venous samples from adults undergoing major noncardiac surgery compared three widely used devices, HemoCue®, i-STAT™, and the Rad-67™ pulse CO-Oxymeter® finger sensor device, against standard laboratory haemoglobin measurements, but importantly not against a blood gas analyser. The study focused on haemoglobin results below 100 g L to establish the utility of these devices to guide red cell transfusion decisions.

View Article and Find Full Text PDF

Management of renin-angiotensin system inhibitors prior to major surgery: insights from the STOP-or-NOT trial.

Br J Anaesth

December 2024

INI-CRCT Network, Nancy, France; Université Paris Cité, AP-HP, Hôpital Lariboisière, DMU PARABOL, Service d'Anesthésie-réanimation-CTB, Paris, France; UMR-942 "MASCOT", Inserm, Paris, France.

Strong recommendations on how to manage renin-angiotensin system inhibitors, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, before surgery are lacking because of a lack of evidence, which is mostly limited to data from observational studies. The STOP-or-NOT trial was a large multicentre randomised trial designed to determine whether chronic renin-angiotensin system inhibitors should be continued or discontinued before major noncardiac surgery. As principal investigators of the STOP-or-NOT trial, we discuss the trial's results and how they contribute to the existing literature on management of renin-angiotensin system inhibitors before surgery.

View Article and Find Full Text PDF

Background: Myocardial injury after noncardiac surgery (MINS) is associated with an increased incidence of cardiac morbidity and mortality. Little is known about how these patients are managed.

Methods: We performed a single-centre retrospective chart review of patients referred to a postoperative clinic with the diagnosis of MINS.

View Article and Find Full Text PDF

Dexamethasone: The Alan Turing of Surgical Site Infection in Noncardiac Surgery.

Anesth Analg

January 2025

Fellow Pain and Palliative Care, Department of Anesthesiology Universidad CES Medellín,

View Article and Find Full Text PDF

Background: Clinical determination of patients at high risk of poor surgical outcomes is complex and may be supported by clinical tools to summarize the patient's own personalized electronic health record (EHR) history and vitals data through predictive risk models. Since prior models were not readily available for EHR-integration, our objective was to develop and validate a risk stratification tool, named the Assessment of Geriatric Emergency Surgery (AGES) score, predicting risk of 30-day major postoperative complications in geriatric patients under consideration for urgent and emergency surgery using pre-surgical existing electronic health record (EHR) data.

Methods: Patients 65-years and older undergoing urgent or emergency non-cardiac surgery within 21 hospitals 2017-2021 were used to develop the model (randomly split: 80% training, 20% test).

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!