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LVAD Patients in Non-Cardiac Surgery: Implications for Anesthetic Management

  • Thoracic Anesthesia (AM Bergmann, Section Editor)
  • Published:
Current Anesthesiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review illustrates the challenge of LVAD patient and proposes a complete approach to this patient in case of non-cardiac surgery for the anesthesiologist.

Recent Findings

The introduction of the left ventricular assist device (LVAD) has improved survival rates of patients with end‐stage heart failure. Improvements in technology together with the results of several trials have led to a widening of indication: initially used as bridge-to-transplant (BTT), nowadays LVAD is implanted also as bridge-to-candidacy (BTC), and more recently as destination therapy (DT). With improve in survival using the latest generation of continuous flow (CF) LVADs and increasing numbers of devices being implanted, the need for non-cardiac surgery (NCS) in this population is growing.

Summary

The aim of this review is to highlight the device characteristics, the LVAD patients’ hemodynamic profile, and the most frequent complications, together with an overview on how to approach these patients when they schedule for elective or emergency non-cardiac surgery (NCS)

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Authors and Affiliations

  1. Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Michele Mondino & Sandra Nonini

  2. Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, University Hospital of Verona, Verona, Italy

    Blanca Martinez Lopez de Arroyabe

Authors
  1. Michele Mondino
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  2. Blanca Martinez Lopez de Arroyabe
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  3. Sandra Nonini
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Correspondence to Michele Mondino.

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Michele Mondino, Blanca Martinez Lopez de Arroyabe, and Sandra Nonini declare they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Mondino, M., Martinez Lopez de Arroyabe, B. & Nonini, S. LVAD Patients in Non-Cardiac Surgery: Implications for Anesthetic Management. Curr Anesthesiol Rep 12, 342–351 (2022). https://doi.org/10.1007/s40140-022-00518-0

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