scholarly journals A Complicated Course of Brain Tumor Resection in a Patient with a Left Ventricular Assist Device

2021 ◽  
Author(s):  
Nimesh Patel ◽  
Mohamed Fayed ◽  
Ahmed Ahmed ◽  
Akshatha G. Rao ◽  
Derrick Williams ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Tumor Resection ◽  
Patient Positioning ◽  
Hemodynamic Instability ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Brain Tumor Resection

AbstractLeft ventricular assist devices (LVAD) are mechanical pumps that have become a standard treatment for end-stage heart failure. As patients with LVAD are living longer, the number of noncardiac surgeries performed in these patients is rising. However, these patients present a unique set of risk factors, some of which include acquired coagulopathies, anticoagulation status, and hemodynamic instability. Thus, performing noncardiac surgeries in patients with an LVAD requires a precise and complex surgical strategy with optimal communication among the surgical team. Therefore, knowledge of best perioperative approaches for patients with LVAD is urgently needed. Here, we present a detailed perioperative surgical approach in the case of a brain tumor resection for a 62-year-old patient with an LVAD whose course was complicated with a brain hematoma. Critical details include key aspects of monitoring patient hemodynamic stability and handling of anesthesia, patient positioning, and antiplatelet and anticoagulation drug therapy. This case highlights the importance for anesthesiologists to be well informed about perioperative LVAD management, as well as common complications that they may encounter.

scholarly journals Successful Perioperative Management of a Patient with the Left Ventricular Assist Device for Brain Tumor Resection: Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Rashmi Vandse ◽  
Thomas J. Papadimos
Keyword(s):  
Heart Failure ◽  
Brain Tumor ◽  
Tumor Resection ◽  
The United States ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Anesthetic Considerations ◽  
Brain Tumor Resection ◽  
Dependent Patient

Heart failure is the leading cause of death in the United States. Our increasingly aged population will contribute to an increased incidence and prevalence of heart failure, thereby augmenting the need for mechanical circulatory devices. Here we present the first successful resection of a brain tumor in a left ventricular device- (LVAD-) dependent patient with increased intracranial pressure and address pertinent perioperative anesthetic considerations and management.

The LVAD Patient Presenting for Noncardiac Surgery

2018 ◽  
pp. 29-42
Author(s):  
Christopher Y. Tanaka ◽  
Elizabeth M. Vue
Keyword(s):  
Hemodynamic Instability ◽  
Left Ventricular ◽  
Noncardiac Surgery ◽  
Ventricular Assist Devices ◽  
Team Approach ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
End Stage

As the number of end-stage heart failure patients steadily grows, more patients are implanted with long-term left ventricular assist devices (LVAD). Increasingly, noncardiac-trained anesthesiologists are caring for LVAD patients presenting for noncardiac surgery. While continuous-flow LVAD physiology creates unique physiologic and management challenges, patients can be safely anesthetized with appropriate education and training. A multidisciplinary team approach is recommended to review potential perioperative issues for each LVAD patient, including cardiovascular status, LVAD function, anticoagulation, and antibiotic prophylaxis. The anesthesiology team should be comfortable managing hemodynamic instability, arrhythmias, and cardiac arrest in LVAD patients. This chapter uses a case study of an LVAD patient presenting for noncardiac surgery as an example.

Devices for Transcatheter Haemodynamic Support for Left Heart Failure

2010 ◽  
Vol 5 (1) ◽  
pp. 16
Author(s):  
Aman Ali ◽  
Timothy A Sanborn ◽  
◽  
Keyword(s):  
Mortality Rate ◽  
Cardiogenic Shock ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Severe Left Ventricular Dysfunction ◽  
Ventricular Assist ◽  
Left Heart Failure ◽  
Assist Devices ◽  
Left Ventricular Assist

Among patients with acute myocardial infarction (AMI), those in cardiogenic shock have the highest mortality rate. Early revascularisation with primary percutaneous intervention or coronary artery bypass surgery has decreased the mortality rate of patients in cardiogenic shock, but it remains high. The conventional treatment of haemodynamic instability has been the use of the intra-aortic balloon pump (IABP); however, the IABP may not give adequate support to patients with severe left ventricular dysfunction. Recent advances in percutaneous left ventricular assist devices, specifically the TandemHeart and Impella LP 2.5, have shown improved haemodynamic support compared with the IABP. This article provides an overview of the use of percutaneous left ventricular assist devices to treat patients presenting with cardiogenic shock after acute MI.

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