Ventricular assist devices in pediatric cardiac surgery

1995 ◽  
Vol 60 ◽  
pp. S536-S538 ◽  
Author(s):  
Robert J. Costa ◽  
Richard B. Chard ◽  
Graham R. Nunn ◽  
Timothy B. Cartmill
1995 ◽  
Vol 60 (6) ◽  
pp. S536-S538
Author(s):  
Robert J. Costa ◽  
Richard B. Chard ◽  
Graham R. Nunn ◽  
Timothy B. Cartmill

Author(s):  
A. Albajar Bobes ◽  
M. Casado Salcedo ◽  
E. Rincón Gómez-Limón ◽  
J.M. Álvarez Avello ◽  
A.I. González Román ◽  
...  

Author(s):  
Uwe Schirmer ◽  
Andreas Koster

Cardiac anaesthesia continues to develop as a specialized discipline within the wide field of clinical anaesthesia. A comprehensive knowledge of cardiovascular physiology and its improved monitoring with modern invasive and non-invasive devices is the basis for the pharmacological treatment of complex cardiovascular disorders. Excellent skills in intraoperative transoesophageal echocardiography have become essential. Rapid developments in cardiopulmonary bypass techniques and surgical devices have resulted in the speedy introduction of new surgical techniques which anaesthesia has to embrace. The developments in the field of (left) ventricular assist devices are expansive. By changing the paradigm of the indication of implantation from ‘bridging to heart transplantation’ to ‘destination therapy’, particularly in the large group of elderly patients with end-stage heart failure, these complex operations are no longer restricted to the small group of heart centres performing heart transplantation. This chapter provides a comprehensive review of modern cardiac anaesthesia in the contemporary world of quickly evolving cardiac surgery. The basics of anaesthesia management for the ‘cardiac’ patient are described and principles of extracorporeal circulation as well as diagnostic and treatment strategies of disturbances of the haemostatic system are highlighted. Pharmacological strategies to treat left- and right-heart failure and strategies for temporary mechanical support are outlined. Further areas of focus are the anaesthetic implications of modern less or minimally invasive procedures such as off-pump coronary artery bypass grafting and minimally invasive valve implantation/surgery and anaesthesia for implantation of ventricular assist devices and heart transplantation.


Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 424
Author(s):  
Rafal Berger ◽  
Attila Nemeth ◽  
Christoph Salewski ◽  
Rodrigo Sandoval Boburg ◽  
Metesh Acharya ◽  
...  

Background and Objectives: Since the first use of ventricular assist devices (VADs) as bridge to recovery and bridge to cardiac transplantation in the early 1990s, significant technological advances have transformed VAD implantation into a routine destination therapy. With improved survival, many patients present for cardiac surgery for conditions not directly related to their permanent mechanical circulatory support. The aim of this study was to analyze the indications and outcomes of non-cardiac surgeries (NCSs) of left ventricular assist device (LVAD) patients in tertiary center. Material and Methods: We present a single-center experience after 151 LVAD implantations in 138 consecutive patients between 2012–2019 who had to undergo NCS during a follow-up period of 37 +/− 23.4 months on left ventricular assist device (LVAD). Results: A total of 105 procedures was performed in 63 LVAD recipients, resulting in peri-operative mortality of 3.8%. Twenty-five (39.7%) of patients underwent multiple surgeries. We found no significant difference in cumulative survival associated with the performed surgical interventions (p = 0.469). Conclusion: We demonstrated good overall clinical outcomes in LVAD patients undergoing NCS. With acceptable peri-operative mortality, NCS can be safely performed in LVAD patients on long-term support.


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