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.

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 Characteristics and Outcomes of COVID-19 in Patients on Left Ventricular Assist Device Support

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Edo Y. Birati ◽  
Samer S. Najjar ◽  
Ryan J. Tedford ◽  
Brian A. Houston ◽  
Supriya Shore ◽  
...  
Keyword(s):  
Heart Failure ◽  
The United States ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Presenting Symptoms ◽  
Left Ventricular Assist ◽  
End Stage Heart Failure ◽  
End Stage

Background: The coronavirus disease 2019 (COVID-19) pandemic continues to afflict millions of people worldwide. Patients with end-stage heart failure and left ventricular assist devices (LVADs) may be at risk for severe COVID-19 given a high prevalence of complex comorbidities and functional impaired immunity. The objective of this study is to describe the clinical characteristics and outcomes of COVID-19 in patients with end-stage heart failure and durable LVADs. Methods: The Trans-CoV-VAD registry is a multi-center registry of LVAD and cardiac transplant patients in the United States with confirmed COVID-19. Patient characteristics, exposure history, presentation, laboratory data, course, and clinical outcomes were collected by participating institutions and reviewed by a central data repository. This report represents the participation of the first 9 centers to report LVAD data into the registry. Results: A total of 40 patients were included in this cohort. The median age was 56 years (interquartile range, 46–68), 14 (35%) were women, and 21 (52%) were Black. Among the most common presenting symptoms were cough (41%), fever, and fatigue (both 38%). A total of 18% were asymptomatic at diagnosis. Only 43% of the patients reported either subjective or measured fever during the entire course of illness. Over half (60%) required hospitalization, and 8 patients (20%) died, often after lengthy hospitalizations. Conclusions: We present the largest case series of LVAD patients with COVID-19 to date. Understanding these characteristics is essential in an effort to improve the outcome of this complex patient population.

Left Ventricular Assist Device Driveline Infections

2015 ◽  
Vol 26 (4) ◽  
pp. 300-305
Author(s):  
Marc Angud
Keyword(s):  
Heart Failure ◽  
Left Ventricular Assist Device ◽  
Heart Transplant ◽  
Ventricular Assist Device ◽  
The United States ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Heart failure is a chronic progressive disease that affects millions of people in the United States. Although medical management of heart failure has helped improve quality of life and survival, end-stage heart failure ultimately requires a heart transplant or long-term left ventricular assist device (LVAD) support. With more patients awaiting transplant, the demand for hearts outweighs the supply of donor hearts. The use of LVADs is increasing in patients with advanced heart failure as a treatment option for those awaiting a heart transplant or as a long-term solution if they are ineligible for a transplant. Although the LVAD is a marvel of modern medicine, infection is a cause of concern because today’s LVADs are powered externally through a percutaneous driveline that can be a major source of infection.

Anesthetic Management for Patients With Left Ventricular Assist Devices Undergoing Noncardiac Surgery

2019 ◽  
pp. 137-145
Author(s):  
Amanda M. Kleiman ◽  
Christopher Spencer ◽  
Julie L. Huffmyer
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
Anesthetic Considerations ◽  
Altered Physiology

The incidence and prevalence of chronic heart failure is increasing in the United States, and end-stage heart failure is associated with high mortality. While medical management is often the first-line treatment of heart failure, mechanical circulatory support and ventricular assist device therapies are being increasingly employed to improve symptoms and end-organ dysfunction from heart failure. Patients with left ventricular assist devices (LVADs) are not only surviving with their disease, but also thriving as a result of LVAD support, and many return to normal activities of daily life. Thus, these patients present to hospitals for noncardiac surgeries, both elective and urgent, with increasing frequency. This chapter explores some commonly used ventricular assist devices, the altered physiology that accompanies LVAD therapy with continuous flow devices, as well as some of the anesthetic considerations that are vital for patients presenting for both elective and urgent surgeries.

Destination to Nowhere: A New Look at Aggressive Treatment for Heart Failure—A Case Study

2014 ◽  
Vol 34 (2) ◽  
pp. 47-56 ◽  
Author(s):  
Brian J. O’Neill ◽  
Meredith W. Kazer
Keyword(s):  
Heart Failure ◽  
Moral Distress ◽  
The United States ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Preparedness Planning ◽  
Palliative Care Teams ◽  
Left Ventricular Assist ◽  
States Experience

Approximately 5.7 million people in the United States experience heart failure, and about 670 000 new cases are diagnosed annually. Patients who are ineligible for heart transplant may benefit from a left ventricular assist device. These devices have provided patients with an increased life span, but eventually patients die of the underlying heart disease. This case study illustrates the appropriate use of palliative care teams to address preparedness planning and help decrease moral distress among nursing staff. (Critical Care Nurse. 2014; 34[2]:47–56)

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