Contents

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Show Summary Details
Page of

Anesthesia 

Anesthesia
Chapter:
Anesthesia
Author(s):

Christopher J. Plambeck

, Michael K. Loushin

, and Michael F. Sweeney

DOI:
10.1093/med/9780190909291.003.0024
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 07 June 2020

The anesthetic care of the left ventricular assist device (LVAD) recipient presents to the anesthesiologist a unique set of challenges which must be skillfully managed for the successful completion of this complex surgical procedure. The anesthesiologist must perform a thorough preoperative evaluation and carefully assess the patient’s cardiovascular, pulmonary, renal, and hepatic systems. Special consideration to the risk of post-implantation right ventricular (RV) dysfunction is critical. In patients with advanced heart failure, a well-formulated anesthetic management plan must be developed to provide adequate anesthesia while at the same time preventing hemodynamic deterioration. The performance of a comprehensive transesophageal echocardiogram study is essential for identifying potential issues that may need to be addressed during the surgery. The post-cardiopulmonary bypass period is fraught with several challenges which the anesthesiologist must address, such as RV dysfunction or failure, vasoplegia, and coagulopathy. The transition of care to the ICU is facilitated by the application of a standardized checklist to ensure that all critical information is conveyed to the critical care providers. The anesthesiologist also frequently provides care for the LVAD patient undergoing a non-cardiac surgery or procedure. A careful preoperative evaluation and a thorough understanding of the technology and physiology of the LVAD patient is essential to the development of a safe and sensible anesthetic management plan.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.