title: Dental treatment of a patient with an implanted left ventricular assist device: expanding the frontiers.
abstract: BACKGROUND
  The left ventricular assist device (LVAD) is used as a bridge to heart transplantation. Currently, these devices are being used for longer periods of time than in previous years for the purpose of bridge to life, thus the need for dental assistance will emerge.
  
  
  METHODS
  A female with severe acute congestive heart failure, owing to dilated cardiomyopathy, needed implantation of an LVAD as a bridge to heart transplantation. Six months after insertion of the device she suffered from spontaneous gingival bleeding and sought dental treatment. She presented with several dento-medical problems that required resolution before commencement of dental treatment.
  
  
  CONCLUSIONS
  Management of a patient with LVAD opens new frontiers for the dental team regarding treatment of the medically severely compromised patient who may present with multiple intervening medical aspects: profound antithrombotic therapy, high risk of device infection, possible magnetic interference with dental instruments, and even assessment of vital signs.
authors: Department of Oral Medicine, Hadassah Hospital, Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel. findler@inter.net.il
authors: Mordechai
authors: M
authors: Findler
authors: Michael
authors: M
authors: Findler
authors: Ehud
authors: E
authors: Rudis
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis; D017742:Dental Care for Chronically Ill; D012534:Dental Scaling; D005260:Female; D005884:Gingival Hemorrhage / Q000150:complications / Q000628:therapy*; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D056888:Patient Positioning; D055986:Vital Signs