Effective Illustration of Decommissioning of Left Ventricular Assist Device after Bridge-to-Recovery by Hybrid Minimally-Invasive Tactic: Anesthesia Substances
| Autor: | Shah Shitalkumar S, Koth, Thay Yu Jia, an Harikrishnan |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Framingham Risk Score business.industry medicine.medical_treatment Pulmonary artery catheter Fluid management 030204 cardiovascular system & hematology Percutaneous approach Nuclear decommissioning Surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine medicine.anatomical_structure 030228 respiratory system Anesthesia Ventricular assist device medicine Vascular resistance Sinus rhythm business |
| Zdroj: | Journal of Anesthesia & Clinical Research. |
| ISSN: | 2155-6148 |
| DOI: | 10.4172/2155-6148.1000702 |
| Popis: | We report successful decommissioning of HeartWare left ventricular assist device (LVAD) (HVAD, HeartWare Inc., Framingham, MA) leaving the pump in situ by hybrid percutaneous approach. In this case, the indication for mechanical assist device separation was myocardial recovery, which occurred following 19 months of LVAD support. Anaesthetic goals include maintenance of sinus rhythm, avoidance of myocardial depression and increase in systemic vascular resistance (SVR), with optimal blood pressure control, normothermia, and judicious fluid management. Intraoperative assessment of suitability to wean using transesophageal echocardiography (TEE) and continuous cardiac output monitoring with pulmonary artery catheter must be expedient as no anticoagulation is given. This case report demonstrates the feasibility of separating a patient from a LVAD without the need for a major re-operative intervention. |
| Databáze: | OpenAIRE |
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