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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2015

Open Access 01-12-2015 | Review

Ventricular assist devices and non-cardiac surgery

Authors: S. Michael Roberts, David G. Hovord, Ramesh Kodavatiganti, Subramanian Sathishkumar

Published in: BMC Anesthesiology | Issue 1/2015

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Abstract

The use of ventricular assist devices has expanded significantly since their approval by the Food and Drug Administration in the United States in 1994. In addition to this, the prevalence of heart failure continues to increase. We aim to provide an overview of perioperative considerations and management of these patients for non-cardiac surgery. We performed a Medline search for the words “ventricular assist device,” “Heartmate” and “HeartWare” to gain an overview of the literature surrounding these devices, and chose studies with relevance to the stated aims of this review. Patients with ventricular assist devices are presenting more frequently for surgery not related to their cardiac pathology. As the mechanically supported population grows, general anesthesiologists will be faced with managing these patients, possibly outside of the tertiary care setting. The unique challenges of this patient population can best be addressed by a thorough understanding of ventricular assist device physiology and a multidisciplinary approach to care.
Literature
1.
Barbara DW, Wetzel DR, Pulido JN, Pershing BS, Park SJ, Stulak JM, et al. The perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery. Mayo Clin Proc. 2013;88(7):674–82.CrossRefPubMed
2.
Slaughter MS, Pagani FD, McGee EC, Birks EJ, Cotts WG, Gregoric I, et al. HeartWare ventricular assist system for bridge to transplant: combined results of the bridge to transplant and continued access protocol trial. J Heart Lung Transplant. 2013;32(7):675–83.CrossRefPubMed
3.
Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation. 2011;123(4):e18–e209.CrossRefPubMed
4.
Eckhauser AE, Melvin WV, Sharp KW. Management of general surgical problems in patients with left ventricular assist devices. Am Surg. 2006;72(2):158–61.PubMed
5.
Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345(20):1435–43.CrossRefPubMed
6.
Rogers JG, Butler J, Lansman SL, Gass A, Portner PM, Pasque MK, et al. Chronic mechanical circulatory support for inotrope-dependent heart failure patients who are not transplant candidates: results of the INTrEPID Trial. J Am Coll Cardiol. 2007;50(8):741–7.CrossRefPubMed
7.
Kartha V, Gomez W, Wu B, Tremper K. Laparoscopic cholecystectomy in a patient with an implantable left ventricular assist device. Br J Anaesth. 2008;100(5):652–5.CrossRefPubMed
8.
Stone ME, Soong W, Krol M, Reich DL. The anesthetic considerations in patients with ventricular assist devices presenting for noncardiac surgery: a review of eight cases. Anesth Analg. 2002;95(1):42–9.CrossRefPubMed
9.
Nicolosi AC, Pagel PS. Perioperative considerations in the patient with a left ventricular assist device. Anesthesiology. 2003;98(2):565–70.CrossRefPubMed
10.
Agarwal S, High KM. Newer-generation ventricular assist devices. Best Pract Res Clin Anaesthesiol. 2012;26(2):117–30.CrossRefPubMed
11.
Oleyar M, Stone M, Neustein SM. Perioperative management of a patient with a nonpulsatile left ventricular-assist device presenting for noncardiac surgery. J Cardiothorac Vasc Anesth. 2010;24(5):820–3.CrossRefPubMed
12.
13.
Lalonde SD, Alba AC, Rigobon A, Ross HJ, Delgado DH, Billia F, et al. Clinical differences between continuous flow ventricular assist devices: a comparison between HeartMate II and HeartWare HVAD. J Card Surg. 2013;28(5):604–10.CrossRefPubMed
14.
15.
16.
Ficke DJ, Lee J, Chaney MA, Bas H, Vidal-Melo MF, Stone ME. Case 6-2010: Non-cardiac surgery in patients with a left ventricular assist device. J Cardiothorac Vasc Anesth. 2010;24(6):1002–9.CrossRefPubMed
17.
Tuzun E, Roberts K, Cohn WE, Sargin M, Gemmato CJ, Radovancevic B, et al. In vivo evaluation of the HeartWare centrifugal ventricular assist device. Tex Heart Inst J. 2007;34(4):406–11.PubMedPubMedCentral
18.
19.
Kocabas S, Askar FZ, Yagdi T, Engin C, Ozbaran M. Anesthesia for ventricular assist device placement: experience from a single center. Transplant Proc. 2013;45(3):1005–8.CrossRefPubMed
20.
Sathishkumar S, Kodavatiganti R, Plummer S, High K. Perioperative management of a patient with an axial-flow rotary ventricular assist device for laparoscopic ileo-colectomy. J Anaesthesiol Clin Pharmacol. 2012;28(1):101–5.CrossRefPubMedPubMedCentral
21.
Aggarwal A, Kurien S, Coyle L, Siemeck R, Tatooles A, Pappas PS, et al. Evaluation and management of emergencies in patients with mechanical circulatory support devices. Prog Transplant. 2013;23(2):119–26.CrossRefPubMed
22.
Menon AK, Gotzenich A, Sassmannshausen H, Haushofer M, Autschbach R, Spillner JW. Low stroke rate and few thrombo-embolic events after HeartMate II implantation under mild anticoagulation. Eur J Cardiothorac Surg. 2012;42(2):319–23.CrossRefPubMed
23.
Slaughter MS, Naka Y, John R, Boyle A, Conte JV, Russell SD, et al. Post-operative heparin may not be required for transitioning patients with a HeartMate II left ventricular assist system to long-term warfarin therapy. J Heart Lung Transplant. 2010;29(6):616–24.CrossRefPubMed
24.
Manger JP, Kern JA, Krupski TL: Partial nephrectomy in a patient with a left ventricular assist device. Case Rep Urol 2011;2011:526903. Epub ahead of print.
25.
Slaughter MS, Pagani FD, Rogers JG, Miller LW, Sun B, Russell SD, et al. Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant. 2010;29(4 Suppl):S1–S39.CrossRefPubMed
26.
Riha H, Netuka I, Kotulak T, Maly J, Pindak M, Sedlacek J, et al. Anesthesia management of a patient with a ventricular assist device for Non-cardiac surgery. Semin Cardiothorac Vasc Anesth. 2010;14(1):29–31.CrossRefPubMed
27.
Crossley GH, Poole JE, Rozner MA, Asirvatham SJ, Cheng A, Chung MK, et al. The heart rhythm society (HRS)/american society of anesthesiologists (ASA) expert consensus statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management this document was developed as a joint project with the american society of anesthesiologists (ASA), and in collaboration with the american heart association (AHA), and the society of thoracic surgeons (STS). Heart Rhythm. 2011;8(7):1114–54.CrossRefPubMed
28.
29.
John R, Kamdar F, Liao K, Colvin-Adams M, Miller L, Joyce L, et al. Low thromboembolic risk for patients with the Heartmate II left ventricular assist device. J Thorac Cardiovasc Surg. 2008;136(5):1318–23.CrossRefPubMed
30.
El-Magharbel I. Ventricular assist devices and anesthesia. Semin Cardiothorac Vasc Anesth. 2005;9(3):241–9.CrossRefPubMed
31.
Morgan JA, Paone G, Nemeh HW, Henry SE, Gerlach B, Williams CT, et al. Non-cardiac surgery in patients on long-term left ventricular assist device support. J Heart Lung Transplant. 2012;31(7):757–63.CrossRefPubMed
32.
Pieri M, Agracheva N, Di Prima AL, Nisi T, De Bonis M, Isella F, Zangrillo A, Pappalardo F: Primary Anticoagulation With Bivalirudin for Patients With Implantable Ventricular Assist Devices. Artif Organs. 2013;38(4):342–6.CrossRefPubMed
33.
Pappalardo F, Scandroglio AM, Potapov E, Stepanenko A, Maj G, Krabatsch T, et al. Argatroban anticoagulation for heparin induced thrombocytopenia in patients with ventricular assist devices. Minerva Anestesiol. 2012;78(3):330–5.PubMed
34.
Garatti A, Bruschi G, Colombo T, Russo C, Milazzo F, Catena E, et al. Non-cardiac surgical procedures in patient supported with long-term implantable left ventricular assist device. Am J Surg. 2009;197(6):710–4.CrossRefPubMed
35.
Pratt AK, Shah NS, Boyce SW. Left ventricular assist device management in the ICU. Crit Care Med. 2014;42(1):158–68.CrossRefPubMed
36.
Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, et al. Part 8: adult advanced cardiovascular life support: 2010 american heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S729–767.CrossRefPubMed
37.
Naitoh T, Morikawa T, Sakata N, Unno M, Akiyama M, Saiki Y. Emergency laparoscopic cholecystectomy for a patient with an implantable left ventricular assist device: report of a case. Surg Today. 2013;43(3):313–6.CrossRefPubMed
38.
The 2013 International Society for Heart and Lung Transplantation Guidelines for Mechanical Circulatory Support: Executive Summary
Metadata
Title
Ventricular assist devices and non-cardiac surgery
Authors
S. Michael Roberts
David G. Hovord
Ramesh Kodavatiganti
Subramanian Sathishkumar
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-015-0157-y

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