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Evaluation and Management of Patients with Left Ventricular Assist Device (LVAD) Requiring Noncardiac SurgicalProcedures

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The High-risk Surgical Patient

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Abstract

The introduction of left ventricular assist device (LVAD) has improved survival rates for patients with end-stage heart failure. Survival rate at one year with the latest generation of continuous flow (CF) LVAD now approaches 80%. They have been approved suitable as a destination therapy (DT) in patients who were not eligible for transplantation. As a result, the LVAD population is growing, and the need for noncardiac surgical procedures (NCSs) in these patients will continue to rise. The anesthesiologist needs to be familiar with these particular types of patients and with these devices. The aim of this chapter is to highlight the devices’ characteristics, the LVAD patients’ hemodynamic profile, and the most frequent complications, together with an overview on how to approach these patients when they present for elective or emergency NCS.

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Authors and Affiliations

  1. Cardiovascular and Thoracic Intensive Care Unit and Anaesthesia, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Michele G. Mondino, Emanuela Paradiso & Sandra Nonini

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  1. Michele G. Mondino
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  2. Emanuela Paradiso
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  3. Sandra Nonini
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Correspondence to Michele G. Mondino .

Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Paolo Aseni

  2. Divisione di Cardiochirurgia, IRCCS Fondazione Policlinico San Matteo, Pavia, Pavia, Italy

    Antonino Massimiliano Grande

  3. Div. of Emerg. Surg., Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland

    Ari Leppäniemi

  4. Department of Pathophysiology and Transplantation, General Surgery and Trauma Team, University of Milano, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Osvaldo Chiara

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Mondino, M.G., Paradiso, E., Nonini, S. (2023). Evaluation and Management of Patients with Left Ventricular Assist Device (LVAD) Requiring Noncardiac SurgicalProcedures. In: Aseni, P., Grande, A.M., Leppäniemi, A., Chiara, O. (eds) The High-risk Surgical Patient. Springer, Cham. https://doi.org/10.1007/978-3-031-17273-1_37

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  • DOI: https://doi.org/10.1007/978-3-031-17273-1_37

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