Intraoperative Management of Left Ventricular Assist Device Explantation: Complications and Lessons Learned

LEFT VENTRICULAR assist devices (LVADs) are increasingly being used in patients with advanced heart failure as a bridge to transplant, destination therapy, and even as a bridge to recovery.1-3 The current contemporary second and third generation LVADs such as the HeartMate 2 and the newer generation HeartMate 3 and HeartWare have evolved to be valveless, which have markedly improved their durability, miniaturization, and reliability.4 However, an underappreciated consequence of the valveless design is that they can lead to marked left ventricular (LV) dilatation and irreversible cardiac injury when they are turned off in emergencies, such as injury to the outflow graft during sternotomy, and may be exacerbated by the use of peripheral cardiopulmonary bypass (CPB) that is often prepared for and employed when complications from difficult redo sternotomies arise.

Source: Journal of Cardiothoracic and Vascular Anesthesia - November 27, 2019 Category: Anesthesiology Authors: Marvin G. Chang, Monica Miller, Adam A. Dalia Tags: Case Report Source Type: research